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Query: EC:4.1.1.15 (
glutamate decarboxylase
)
2,169
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The prevalence of glutamic acid decarboxylase autoantibodies was determined with an immunotrapping enzyme activity assay in newly-diagnosed Type 1 (insulin-dependent) diabetic patients as well as in first-degree relatives using rat brain homogenate as a source of
glutamate decarboxylase
. Twenty-six out of 86 islet-cell cytoplasmic auto-antibody positive and one out of 24 islet cell autoantibody negative patients of recent onset, had autoantibodies to
glutamate decarboxylase
above the upper 99% confidence limit obtained from 89 control sera. Among 27 islet cell autoantibody positive relatives including 19 siblings and 8 parents, antibodies to
glutamate decarboxylase
were found in 8 of 9 (89%) relatives and 7 of 8 (87.5%) siblings with islet cell auto-antibody titres above 20 JDF units, in 1 of 19 (5.2%) relatives with islet cell autoantibody titres between 2 and 5 JDF units, in 2 of 263 (0.7%) siblings and 1 of 139 parents without islet cell autoantibodies. In first-degree relatives, high titre islet cell autoantibodies and autoantibodies to
glutamate decarboxylase
were tightly associated (X2 = 182, p = 0.0001). None of the relatives with low genetic risk (n = 64), i.e.
HLA
-different to the diabetic proband, was found to be antibody positive. Antibodies to
glutamate decarboxylase
were present only in those relatives sharing at least one haplotype with the diabetic proband, including two islet cell autoantibody negative but
HLA
-identical siblings. Autoantibodies to
glutamate decarboxylase
were present in 7 of 9 (77%) relatives who developed the disease, including one islet cell autoantibody negative sibling.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Glutamic acid decarboxylase (GAD) autoantibodies are additional predictive markers of type 1 (insulin-dependent) diabetes mellitus in high risk individuals. 161 31
Most autoimmune diabetes occurs in those without a diabetic relative, but few cases are identifiable prospectively. To model general population prediction, 491 consecutive newly diabetic children from all of Sweden were tested for autoantibodies to
glutamate decarboxylase
(GAD65ab), insulin (IAA), and islet cells (ICA), and for HLA-DQ genotypes by PCR; 415 matched control children were tested in parallel. GAD65ab sensitivity/specificity was 70/96%, versus 84/96% for ICA, 56/97% for IAA, 93/93% (any positive), 39/99.7% (all positive), and 41/99.7% (GAD65ab plus IAA). The latter's 25% predictive value was not improved by requiring concomitant high-risk
HLA
genotypes. GAD65ab were associated with DQA1*0501/B1*0201 (DQ2; P = 0.007) but not DQA1*0301/B1*0302 (DQ8), and IAA with DQA1*0301/B1*0302 (DQ8; P = 0.03) but not DQA1*0501/B1*0201 (DQ2). GAD65ab were more prevalent in females than males (79 vs. 63%; P < 0.0001) but did not vary with onset age nor season. Combining the three antibody assays yielded sufficient sensitivity for screening. GADab were relatively sensitive/specific for diabetes, but even with
HLA
marker combinations yielded predictive values insufficient for early immunointervention in the low-prevalence general population.
...
PMID:Glutamate decarboxylase-, insulin-, and islet cell-antibodies and HLA typing to detect diabetes in a general population-based study of Swedish children. 770 55
Autoreactive islet cell Abs (ICA) accompany the pathogenic destruction of pancreatic beta cells in insulin-dependent diabetes mellitus (IDDM). Human monoclonal ICA (MICA 1-6), previously derived from a DR1/DR7-positive newly diagnosed diabetic patient, recognized the islet cell autoantigen
glutamate decarboxylase
65 (GAD65) and defined two distinct conformational (MICA 1/3 and MICA 4/6) and one linear (MICA 2) autoimmune epitopes in this molecule. We have isolated 4 new ICA-reactive B cell lines, one from a DR4/DR11-positive newly diagnosed IDDM patient (MICA 7) and three from a DR3 homozygous patient with both IDDM and Graves' disease (MICA 8-10). Like MICA 1-6, MICA 7-10 are specific for GAD65, suggesting that GAD65-reactive B cells dominate the ICA response in IDDM. Comparative analysis of MICA 1-6 and MICA 7-10, using GAD65 mutants and blocking experiments, showed that MICA 7-10 define three novel conformational autoimmune epitopes in GAD65. Further structural analysis of the MICA 1-10 epitopes revealed two distinct and one overlapping region of epitope clusters. Thus, the C-terminal region, defined by amino acids 450 to 570, harbors the conformational MICA1/3 and MICA 7 epitopes as well as the linear epitope of MICA 2 (amino acids 506-531). The MICA 4/6 and MICA 10 epitopes are located in the middle region of the molecule defined by amino acids 245 to 449, whereas the N-terminal region contributes only to the MICA 8/9 epitopes (encompassed in amino acids 39-585). MICA 1-6, 7, and 8-10, derived from three IDDM patients of different
HLA
haplotypes, define six different epitopes in GAD65 and represent tools to determine the spectrum, possible
HLA
association, and temporal order of epitope recognition in IDDM.
...
PMID:Immune reactivity of diabetes-associated human monoclonal autoantibodies defines multiple epitopes and detects two domain boundaries in glutamate decarboxylase. 894 34
The Belgian Diabetes Registry (BDR) has studied the epidemiology of Type 1 diabetes with clinical onset before age 40 years in the Antwerp district. Both in the age categories 0-14 years and 15-39 years, the incidence approximates 10 new cases per 100,000 inhabitants per years. Most patients are adults. Juvenile-onset diabetic patients who were so far more intensively studied must therefore not be considered as "prototypes" for the disease, but rather represent "atypical" cases with rapid evolution. Participation in international programs (EURODIAB ACE, DIAMOND) has characterized the incidence of Type 1 diabetes in Belgium as being intermediate between values in low-incidence regions (5 to 10 cases/100,000 inhabitants/yr such as in parts of Southern or Eastern Europe) and values in high-incidence regions 30 to 40 cases/100,000 inhabitants/yr such as in Finland and Sardinia). Type 1 diabetes is a heterogenous disease in terms of clinical presentation, etiological factors and biological markers. Clinical and fundamental research on Type 1 diabetes needs to study patient groups which faithfully reflect this heterogeneity. This is best achieved by recruiting patients through diabetes registries. In Belgium, the BDR presently registers about 40% of all new cases of Type 1 diabetes with onset before age 40 years. Until now, more than 1700 patients and about 1100 first degree relatives are registered. This group is representative of the Belgian population of Type 1 diabetic patients with onset before age 40 years. High quality-assays for immune and genetic markers of Type 1 diabetes were designed and validated through repeated participation in international quality control programs. By systematically performing these assays on the representative non-selected samples of BDR-patients, it became possible to further clarify the clinical biology of Type 1 diabetes and to demonstrate hitherto unrecognized associations among disease markers. Certain of these markers (insulin auto-antibodies, IAA; islet cell antibodies, ICA;
HLA
DQA1*0301-DQB1*0302 risk haplotype) are more frequent for clinical onset before age 10 years and appear associated in that age category. Other markers (
glutamate decarboxylase
antibodies; GAD-Ab) occur more frequently at onset between age 10 and 40 years, where they are preferentially associated with increased genetic risk. Yet another genetic marker (1/1 susceptibility genotype in the 5' polymorphic region of the insulin gene) occurs regardless of age and presence of auto-antibodies, preferentially in patients without the highest
HLA
-linked genetic risk. Age-dependent differences in marker frequency and -associations possibly reflect age-dependent differences in etiological factors, in order of appearance of biological markers, or in progression rate of the disease. Presently, more than 90% of the patients under age 40 years carry at least one diabetes-associated immune or genetic marker, which opens perspectives for a better classification of the disease, especially in adults. Preliminary follow-up studies in first-degree relatives of registered patients confirm the diabetes-predictive value of the markers studied. A group of subjects at high risk for the disease could thus be identified. These subjects qualify for participation in preventive intervention trials. In this respect BDR officially represents Belgium in several international programs: EURODI-AB ACE for marker-studies, ICARUS for diabetes prediction, ENDIT for diabetes-prevention and GETREM for optimal diabetes treatment. This collaboration will focus in the near future on neonatal screening and follow-up, objective classification criteria for diabetes in adults, refined diabetes-prediction and preventive intervention studies. BDR may also serve as a tool for systematic research on the complications, innovative treatments and socio-economical aspects of diabetes.
...
PMID:The importance of diabetes registries and clinical biology for the study and treatment of type 1 (insulin-dependent) diabetes mellitus. 900 3
Glutamic acid decarboxylase isoform 2 (GAD65;
EC 4.1.1.15
) has been identified as a key target autoantigen of insulin-dependent diabetes mellitus (IDDM). IDDM is genetically associated with the major histocompatibility complex (MHC), and particular alleles from the HLA-DQ and HLA-DR loci contribute to disease. Among DR4 subtypes,
HLA
-DRB1*0401, HLA-DRB1*0402, and
HLA
-DRB1*0405 alleles lend susceptibility, while
HLA
-DRB1*0403 confers protection. We have utilized HLA-DR(alpha1*0101,beta1*0401) (hereafter referred to as DR0401), human CD4, murine class II null triple transgenic mice and recombinant GAD65 to generate T cell hybridomas, and we have used overlapping sets of peptides to map the immunodominant epitopes of this autoantigen. We have identified 10 immunogenic regions for GAD65, of which 6 are recognized by multiple hybridomas. These epitopes are also generated by human antigen-presenting cells and their presentation is DR0401 restricted, as shown by the use of typed human lymphoblastoid cell lines and antibody blocking experiments. Immunodominant GAD65 epitopes defined in transgenic mice correspond to GAD65 regions previously shown to elicit T cell responses specifically in DR0401 IDDM patients, underscoring the validity of this approach. Interestingly, although the major epitopes contain DR0401 binding motifs, one of the epitopes contains a DR0405 motif.
...
PMID:Identification of immunodominant T cell epitopes of human glutamic acid decarboxylase 65 by using HLA-DR(alpha1*0101,beta1*0401) transgenic mice. 922 18
Apart from genes in the
HLA
complex (IDDM1) and the variable number of tandem repeats in the 5' region of the insulin gene (INS VNTR, IDDM2), several other loci have been proposed to contribute to IDDM susceptibility. Recently, linkage and association have been shown between the cytotoxic T lymphocyte-associated protein 4 (CTLA-4) gene on chromosome 2q and IDDM. In a registry-based group of 525 recent-onset IDDM patients <40 years old we investigated the possible interactions of a CTLA-4 gene A-to-G transition polymorphism with age at clinical disease onset and with the presence or absence of established genetic (HLA-DQ, INS VNTR) and immune disease markers (autoantibodies against islet cell cytoplasm (ICA); insulin (IAA);
glutamate decarboxylase
(GAD65-Ab); IA-2 protein tyrosine phosphatase (IA-2-Ab)) determined within the first week of insulin treatment. In new-onset IDDM patients. G-allele-containing CTLA-4 genotypes (relative risk (RR)= 1.5; 95% confidence interval (CI) = 1.2-2.0; P < 0.005) were not preferentially associated with age at clinical presentation or with the presence of other genetic (HLA-DR3 or DR4 alleles;
HLA
-DQA1*0301-DQB1*0302 and/or DQA1*0501-DQB1*0201 risk haplotypes; INS VNTR I/I risk genotype) or immune (ICA, IAA, IA-2-Ab, GAD65-Ab) markers of diabetes. For 151 patients, thyrogastric autoantibodies (anti-thyroid peroxidase, anti-thyroid-stimulating hormone (TSH) receptor, anti-parietal cell, anti-intrinsic factor) were determined, but association between CTLA-4 risk genotypes and markers of polyendocrine autoimmunity could not be demonstrated before or after stratification for
HLA
- or INS-linked risk. In conclusion, the presence of a G-containing CTLA-4 genotype confers a moderate but significant RR for IDDM that is independent of age and genetic or immune disease markers.
...
PMID:CTLA-4 gene polymorphism confers susceptibility to insulin-dependent diabetes mellitus (IDDM) independently from age and from other genetic or immune disease markers. The Belgian Diabetes Registry. 935 55
Studies on pathogenesis of neonatal diabetes may lead to better understanding of pancreatic beta-cell maturation and regulation of insulin secretion. The purpose of this study was to examine the clinical course, immunologic and genetic background of the transient and permanent form of neonatal diabetes. Clinical data (onset and duration of diabetes, C peptide levels, duration of insulin treatment, associated disorders) were collected, islet cell specific antibodies (islet cell antibody and
glutamate decarboxylase
antibody) were determined and genetic analyses (HLA DQA1-DQB1 typing and microsatellite mapping on chromosome 6) were performed in three patients with permanent and three patients with transient neonatal diabetes. None of the six patients had
HLA
DQ diabetes susceptibility alleles and most infants were negative for islet cell autoantibodies indicating that no pancreatic islet-cell specific autoimmunity exists in the two forms of neonatal diabetes mellitus. Complete paternal uniparental isodisomy of chromosome 6 has been identified in a transient neonatal diabetes case with macroglossia. The permanent neonatal diabetes cases and the other two cases with transient form did not possess this chromosome anomaly. It is concluded, that none of the two forms neonatal diabetes is of autoimmune origin. They have different genetic background and represent different disease entities. Transient neonatal diabetes is probably caused by alteration of expression of an imprinted gene on chromosome 6 which might play role in fetal growth and pancreatic beta-cell maturation and insulin secretion. Permanent neonatal diabetes is probably a more heterogenous phenotype, the cause of which remains to be clarified in the future.
...
PMID:[Pathogenesis and types of neonatal diabetes]. 1100 9
MMDM patients are typically young at onset with low body mass index, require insulin treatment for glycemic control, have insulin resistance, and do not develop ketosis on withdrawal of insulin. WHO's revised classification in 1999, based on the etiopathogenesis of the disease, identifies only two categories: type 1 diabetes and type 2 diabetes. MMDM could be considered as type 1b diabetes. Genetic and immunological studies were done on MDDM patients (n = 72) from Cuttack and healthy controls to understand and to justify its inclusion in the category of type 1b diabetes. Antibodies (Abs) to tyrosine pyrophosphatase (IA2-Abs),
glutamate decarboxylase
65 (GAD65-Abs), and other minor markers like ICA12 Abs and tissue transglutaminase Abs (TTG-Abs) were studied. HLA-DR and DQ were studied for the genetic markers. Of the MMDM patients 30% were positive for either GAD65 or IA-2 antibodies, and 14% were positive for ICA12 antibodies. All three antibody markers together accounted for 39% of PDDM patients, as some patients were positive for more than one autoantibody. TTG antibodies (specific for Celiac disease) were present in 14/71 (20%) of MMDM patients compared to 3/122 (2%) controls. All four autoantibodies accounted for 53% of PDDM patients, leaving 47% of patients free of known autoantibodies. The autoantibody-negative PDDM patients were analyzed for
HLA
and MICA markers, showing that DR7-DQ9 and MICA allele 9 are increased in this group compared to healthy controls, which suggests an autoimmune response to an unknown dietary autoantigen. We conclude from our data that an autoimmune mechanism is involved in the etiology of MMDM. In addition, the presence of silent celiac disease seen with MMDM patients, which has not yet been reported, is significant. It is important to note that subclinical celiac disease exists with diabetes mellitus and must be considered in the diagnosis of MMDM.
...
PMID:Molecular mechanisms involved in the etiopathogenesis of malnutrition-modulated diabetes mellitus. 1202 Oct 93
We examined the frequencies of autoantibodies to
glutamate decarboxylase
, GAD65, protein tyrosine phosphatase, IA-2/ICA512, and insulin, and of HLA class II markers in ICA-positive first-degree relatives of patients with type 1 diabetes. Our results indicate that while the presence of
HLA
susceptibility markers is associated with anti-islet autoantibodies, protective DQB1 markers do not absolutely prevent development of autoantibodies or progression to autoimmune diabetes.
...
PMID:Autoantibodies and HLA susceptibility markers in Canadian first-degree relatives of patients with type 1 diabetes. 1202 Nov 12
HLA
-DM stabilizes peptide-receptive class II alphabeta dimers and facilitates the capture of high affinity peptides, thus influencing the peptide repertoire presented by class II molecules. Variations in DM levels may therefore have a profound effect on the antigenic focus of T cell-mediated immune responses. Specifically, DM expression may influence susceptibility and resistance to autoimmune diseases. In this study the role of DM in HLA-DR4-restricted presentation of an insulin-dependent diabetes mellitus autoantigen,
glutamate decarboxylase
(
GAD
), was tested. Presentation of immunodominant
GAD
epitope 273-285 was regulated by endogenous DM levels in human B lymphoblasts. T cell responses to exogenous
GAD
as well as an endogenous cytoplasmic form of this Ag were significantly diminished with increasing cellular expression of DM. Epitope editing by DM was observed only using Ag and not small synthetic peptides, suggesting that this process occurred within endosomes. Results with cytoplasmic
GAD
also indicated that peptides from this compartment intersect class II proteins in endocytic vesicles where DM editing was facilitated. Changes in DM levels within APC may therefore influence the presentation of autoantigens and the development of autoimmune disorders such as type I diabetes.
...
PMID:Editing of an immunodominant epitope of glutamate decarboxylase by HLA-DM. 1284 54
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