Beta‐cell, thyroid, gastric, adrenal and coeliac autoimmunity and HLA‐DQ types in type 1 diabetes

The autoimmune attack in type 1 diabetes is not only targeted to β cells. We assessed the prevalence of thyroid peroxidase (aTPO), parietal cell (PCA), antiadrenal (AAA) and endomysial antibodies (EmA‐IgA), and of overt autoimmune disease in type 1 diabetes, in relation to gender, age, duration of d...

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Published in:	Clinical and experimental immunology Vol. 126; no. 2; pp. 236 - 241
Main Authors:	De Block, C. E. M., De Leeuw, I. H., Vertommen, J. J. F., Rooman, R. P. A., Du Caju, M. V. L., Van Campenhout, C. M., Weyler, J. J., Winnock, F., Van Autreve, J., Gorus, F. K.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01-11-2001 Blackwell Oxford University Press Blackwell Science Inc
Subjects:	Adolescent Adrenal Glands - immunology Adult Autoantibodies - blood Autoimmunity Biological and medical sciences Celiac Disease - immunology Child Diabetes Mellitus, Type 1 - genetics Diabetes Mellitus, Type 1 - immunology Endocrinopathies Female Genetic Linkage Glutamate Decarboxylase - immunology HLA-DQ Antigens - genetics HLA‐DQ type Humans Hypothalamus. Hypophysis. Epiphysis (diseases) Iodide Peroxidase - immunology Male Medical sciences Non tumoral diseases. Target tissue resistance. Benign neoplasms Organ Specificity organ‐specific antibodies Parietal Cells, Gastric - immunology Renal Disease type 1 diabetes β‐cell antibodies Endocrinopathy HLA-System Prevalence Major histocompatibility system Class II histocompatibility antigen Autoimmune disease Lyases Thyroid gland HLA-DQ-Locus Association Carboxy-lyases Organ specificity β Cell Pancreas Endocrine pancreas Human Immunopathology Stomach Enzyme Antibody Langerhans islet Autoantibody Glutamate decarboxylase Carbon-carbon lyases Risk factor Insulin dependent diabetes
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Summary:	The autoimmune attack in type 1 diabetes is not only targeted to β cells. We assessed the prevalence of thyroid peroxidase (aTPO), parietal cell (PCA), antiadrenal (AAA) and endomysial antibodies (EmA‐IgA), and of overt autoimmune disease in type 1 diabetes, in relation to gender, age, duration of disease, age at onset, β‐cell antibody status (ICA, GADA, IA2A) and HLA‐DQ type. Sera from 399 type 1 diabetic patients (M/F: 188/211; mean age: 26 ± 16 years; duration: 9 ± 8 years) were tested for ICA, PCA, AAA and EmA‐IgA by indirect immunofluorescence, and for IA2A (tyrosine phosphatase antibodies), GADA (glutamic acid decarboxylase‐65 antibodies) and aTPO by radiobinding assays. The prevalence rates were: GADA 70%; IA2A, 44%; ICA, 39%; aTPO, 22%; PCA, 18%; EmA‐IgA, 2%; and AAA, 1%. aTPO status was determined by female gender (β = − 1·15, P = 0·002), age (β = 0·02, P = 0·01) and GADA + (β = 1·06, P = 0·02), but not by HLA‐DQ type or IA2A status. Dysthyroidism (P < 0·0001) was more frequent in aTPO + subjects. PCA status was determined by age (β = 0·03, P = 0·002). We also observed an association between PCA + and GADA + (OR = 1·9, P = 0·049), aTPO + (OR = 1·9, P = 0·04) and HLA DQA10501‐DQB10301 status (OR = 2·4, P = 0·045). Iron deficiency anaemia (OR = 3·0, P = 0·003) and pernicious anaemia (OR = 40, P < 0·0001) were more frequent in PCA + subjects. EmA‐IgA + was linked to HLA DQA10501‐DQB10201 + (OR = 7·5, P = 0·039), and coeliac disease was found in three patients. No patient had Addison's disease. In conclusion, GADA but not IA2A indicate the presence of thyrogastric autoimmunity in type 1 diabetes. aTPO have a female preponderance, PCA are weakly associated with HLA DQA10501‐DQB10301 and EmA‐IgA + with HLA DQA10501‐DQB10201.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0009-9104 1365-2249
DOI:	10.1046/j.1365-2249.2001.01668.x