CD95 (Fas Receptor) As A Biomarker Of Β-Cell Apoptosis In Children With Type 1 Diabetes Mellitus Following COVID-19 Infection
Keywords:
Type 1 diabetes mellitus, COVID-19, CD95Abstract
Background: The COVID-19 pandemic has been associated with increased incidence and severity of type 1 diabetes mellitus (T1DM) in children, but pathogenic mechanisms remain unclear.
Objective: To investigate CD95 (Fas receptor) as a biomarker of β-cell apoptosis in children with T1DM following COVID-19 and assess its prognostic value.
Methods: Prospective cohort study of 100 children (6-17 years) with newly diagnosed T1DM: 50 with confirmed prior SARS-CoV-2 infection and 50 controls. Serum CD95, autoantibodies (anti-GAD, anti-IAA, anti-ICA), inflammatory markers (IL-6), and endothelial dysfunction markers (ICAM-1, VCAM-1) were measured at diagnosis, 6, and 24 months.
Results: Post-COVID-19 patients showed markedly elevated CD95 (249.5±72.3 vs. 4.87 pg/mL in controls, p<0.001), representing >50-fold increase. CD95 correlated significantly with autoantibody titers (r=0.58, p<0.001), IL-6 (r=0.67, p<0.001), and disease severity. The post-COVID-19 group had higher diabetic ketoacidosis frequency (38% vs. 16%, p<0.05), greater metabolic decompensation (HbA1c 10.6±2.5% vs. 9.12±0.46%, p<0.05), and no remission phase. A combined risk score incorporating CD95 >100 pg/mL, IL-6 >5 pg/mL, VCAM-1 >150 ng/mL, and ≥2 autoantibodies predicted severe disease (sensitivity 92.1%, specificity 90.0%, AUC 0.94).
Conclusions: CD95 is a valuable biomarker of accelerated β-cell apoptosis in post-COVID-19 T1DM, enabling risk stratification and personalized management.
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Copyright (c) 2026 Malika D. Aripova, Feruza A. Khaydarova
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