Serum TRAIL levels increase shortly after insulin therapy and metabolic stabilization in children with type 1 diabetes mellitus

TNF-related apoptosis-inducing ligand (TRAIL) is a member of the TNF superfamily, which plays an important role in regulating cell death and inflammation. Beyond its anti-tumor activity, increasing evidence in animal studies suggests that TRAIL plays a role in the control of autoimmune diseases, and in particular in type 1 diabetes mellitus (T1DM). In this context, in a previous study carried out in a retrospective cohort of T1DM pediatric patients, we found significant lower levels of circulating TRAIL in T1DM patients with respect to healthy age-matched controls. However, a limitation of our previous study was as follows: (1) the lack of serial serum samples harvested from the same patients at different time post onset and (2) the lack of information about concurrent metabolic status at time of blood sampling. On these bases, the aim of the present study was to analyze the evolution of circulating TRAIL levels in a pilot group of pediatric patients admitted at Emergency Department for T1DM, from the time of hospital admission throughout the re-establishment of a normal metabolic balance and up to 18 months of clinical follow-up. Moreover, the serum levels of TRAIL in T1DM patients were analyzed in relation to the metabolic status determined at the same times.