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Query: UMLS:C0011854 (
type 1 diabetes
)
20,749
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Family and population studies indicate that predisposition to insulin-dependent (type I) diabetes mellitus (
IDDM
) is polygenic. It has been shown that the absence of the
aspartic acid
in position 57 (Asp57) of the DQ beta chain is positively correlated to
IDDM
. However, Asp57-negative haplotypes do not always confer susceptibility and conversely, some Asp57-positive haplotypes seem to be disease associated. It has been suggested that other HLA class II sequences, probably belonging to the HLA DQA1 gene, confer susceptibility to
IDDM
. This report, based on extensive oligonucleotide dot blot hybridization of PCR-amplified DQA1 and DQB1 genes, reinforces the importance of the Asp57-negative DQ beta chain, but also introduces the possibility that a DQ alpha chain bearing an arginine in position 52 (Arg52) confers susceptibility to
IDDM
. A molecular model of susceptibility to
IDDM
is proposed. This model strongly suggests that the disease susceptibility correlates quantitatively with the expression at the cell surface of a heterodimer, composed of a DQ alpha-chain bearing an Arg52 and a DQ beta chain lacking an Asp57. In view of the respective positions of the two residues and their charge, we might anticipate that both residues DQ beta Asp57 and DQ alpha Arg52 are critical for modulation of susceptibility, presumably via viral-antigenic peptide and/or autoantigen presentation.
...
PMID:A combination of HLA-DQ beta Asp57-negative and HLA DQ alpha Arg52 confers susceptibility to insulin-dependent diabetes mellitus. 231 83
The present knowledge of the HLA system and its biological function is summarized as a basis for the subsequent discussion of the associations between this system and insulin-dependent diabetes (
IDDM
) and some mechanisms that may explain them. Although the serologically detectable DR determinants are still the most handy markers, there is now increasing evidence from studies of restriction enzyme fragment length polymorphism (RFLP) in
IDDM
that DQ determinants may play a primary role in causing susceptibility and/or resistance to this disease. Thus, it is now evident that about 90% of DR4-positive diabetics carry the DQw8 determinant present in only about 65% of DR4-positive controls. Most recently, it has been claimed that an
aspartic acid
in position 57 of the DQB1 (DQ-beta-1) chain confers resistance to
IDDM
. Although this may be true, it does not explain the disproportionate decrease of DR2 or the particularly high risk of DR3/4 heterozygotes, which is still good evidence that several HLA genes are involved. Because Class II antigens show the strongest associations, the most plausible hypothesis about the mechanism(s) involves specific presentation of as yet unknown antigenic peptides to T-helper lymphocytes, which may induced the formation of both anti-islet cell antibodies and T-cytotoxic lymphocytes capable of destroying beta cells. However, T-suppressor lymphocytes also may be involved. If this hypothesis is correct, the most urgent task is to define the antigenic peptides in question, whether they are environmental (e.g., viral) or autologous.
...
PMID:HLA and insulin-dependent diabetes: an overview. 265 26
We examined the prevalence of HLA-DRB1, DQB1, DQA1 and TAP2 genes in children with insulin-dependent diabetes mellitus (
type 1 diabetes
). These HLA and TAP2 alleles were identified by dot-blot analysis of polymerase chain reaction (PCR)-amplified genomic DNA with sequence-specific oligonucleotide probes. The results show that those DQB1 alleles, which carry non-
aspartic acid
at position 57, in conjunction with DQA1 alleles carrying arginine at position 52, are strongly associated with susceptibility to
type 1 diabetes
. The prevalence of the TAP2* 0201 allele in diabetic patients was significantly lower than that in normal controls. Analysis of the data suggests that DQ alleles have the primary association with
type 1 diabetes
and that the association of TAP2 alleles with the disease is secondary.
...
PMID:HLA-DQ and TAP2 genes in patients with insulin-dependent diabetes mellitus. 800 38
Insulin-dependent diabetes mellitus
(
IDDM
) is strongly associated with the presence of arginine in position 52 of the DQ alpha chain and absence of
aspartic acid
in position 57 of the DQ beta chain in Caucasians. With the aim of confirming this association in Chinese, extensive oligonucleotide dot blot hybridization of PCR-amplified DQA1 and DQB1 genes was studied using samples from 48
IDDM
patients and 46 healthy nondiabetic control subjects. Three major findings emerged from our analysis. 1) DQ alpha 52-Arg and DQ beta 57-non-Asp are strongly associated with
IDDM
susceptibility as compared with controls (P < 0.001 and 0.005, respectively). 2) DQ beta 57-non-Asp homozygous (NA/NA) is associated with increased susceptibility to
IDDM
(22.9% vs 2.2% in controls, P < 0.01). DQ beta 57-Asp homozygous (A/A) is associated with protection against
IDDM
(14.6% vs 47.8% in controls, P < 0.01). 3) In this study, about 14.6% of
IDDM
patients were homozygous for DQ beta 57-Asp, compared with 0% of American patients. Only 22.9% were homozygous for DQ beta 57-Asp, compared with 96% of American diabetic subjects in a previous study. Thus it is unlikely that the DQ beta 57 amino acid has a major effect on
IDDM
susceptibility in Chinese.
...
PMID:HLA-DQA and DQB alleles contribute to susceptibility to insulin-dependent diabetes mellitus. 803 70
We examined HLA Class II antigens in 116 Japanese
IDDM
patients [84 typical
IDDM
(T-IDD); 32 slowly progressive
IDDM
(S-IDD)] by the hybridization protection assay (HPA) which is a novel HLA typing method based on hybridization of acridinium-ester-labeled DNA probes to amplified DNA. We detected HLA-DRB1, -DQA1 and -DQB1 genes by this method which is capable of analyzing over 50 samples within 4 h with high sensitivity. Positive associations were found in DRB1*0405, DRB1*0802, DRB1*0901, DQA1*0301, DQB1*0303 and DQB1*0401, negative correlations in DRB1*0403, DR2, DR12, DRB1*0801 or 03, DQA1*0101 or 02, DQA1*0501, DQB1*0301 and DQB1*0602 alleles. The absence of
aspartic acid
(
Asp
) at position 57 of the DRB1 chain and the presence of arginine (Arg) at position 52 of the DQA1 chain correlated positively with both types of
IDDM
. There were no significant differences in HLA between T-
IDD
and S-
IDD
. These results suggest that the absence of
Asp
at position 57 of the DRB1 chain and the presence of Arg at position 52 of the DQA1 chain are significant Japanese
IDDM
patients and that DRB1*0802, in which the amino acid at position 57 is
aspartic acid
, may play a role in the pathogenesis of
IDDM
. Also, T-
IDD
and S-
IDD
have common bases in the HLA gene.
...
PMID:Analysis of MHC class II antigens in Japanese IDDM by a novel HLA-typing method, hybridization protection assay. 807 Mar 5
IDDM
patients of North East Italian region were molecularly typed for their HLA-DQB1 and DQA1 loci by using allele specific oligonucleotide probes and PCR amplified genomic DNA.
IDDM
status strongly correlated with DQB1 alleles carrying a non-
aspartic acid
residue in position 57 of DQ beta chain and DQA1 alleles with an arginine residue in position 52 of DQ alpha chain. Genotype analysis revealed that individuals with two DQB1 alleles having a non-aspartic residue in position 57 and two DQA1 alleles with an arginine residue in position 52 had the highest relative risk of disease: they constituted 41% of
IDDM
patients as compared to 0% of controls. Heterozygosity either at residue 57 of DQB1 or residue 52 of DQA1 was sufficient to abrogate statistical significance for disease association, although 43.6% of
IDDM
patients were included in these two groups as compared to 21.6% of normal controls. On the other hand the presence of two DQB1 alleles with
aspartic acid
in position 57 was sufficient to confer resistance to disease irrespective of the DQA1 genotype. Based on the number of possible susceptible heterodimers an individual can form, it was found that 85% of
IDDM
cases could form two or more heterodimers (two in cis and two in trans), but no
IDDM
case was found to form one susceptible heterodimer in cis. These results demonstrate that the complete HLA-DQ genotype, more than single DQB1 or DQA1 alleles or DQB1-DQA1 haplotypes, is associated with the highest risk of disease. Screening of the population for preventive purposes and/or early signs of
IDDM
should then take advantage of this result and "susceptible homozygous" individuals should be followed very closely and considered the first group of choice for possible new therapeutical trials.
...
PMID:The complex interplay of the DQB1 and DQA1 loci in the generation of the susceptible and protective phenotype for insulin-dependent diabetes mellitus. 818 82
In the last few years the improvement of our knowledge of the pathogenesis of
type I diabetes mellitus
has been possible mainly because of the development of studies of the role played by genetic factors and the better definition of lesion mechanisms. The availability of experimental models such as "non obese diabetic (NOD)" mice and "Bio-Breeding (BB)" rats, which develop a form of type I diabetes similar to that of humans, has provided many data regarding the relevance of T lymphocytes in the pathogenesis of the disease, and made it possible to anticipate the immunopathological steps leading to pre-insulitis, insulitis and, finally, to pancreatic beta-cell destruction. The analysis of sera of patients with type I diabetes has demonstrated the presence, also in the preclinical states, of several autoantibodies directed against specific autoantigenic structures of beta cells, which have come to be useful for early diagnosis and in the monitoring of the disease. However, hard evidence for a relevant role of these autoantibodies in the pathogenesis of the disease does not exist. At present, we can affirm that the expansion of autoreactive T lymphocytes specific for membrane antigens of beta cells is the most relevant immunological event for the induction and sustenance of insular lesions. Autoreactive T lymphocytes may be able to activate several effector systems of lesions through the production of multiple combinations of cytokines. The aetiology of the disease is certainly multifactorial and involves both genetic and environmental factors. With respect to the former, the most accurate studies have been performed on the HLA system. It has been clearly shown that type I diabetic patients more frequently display HLA DR3 and DR4 specificities. The results obtained by the application of molecular techniques have suggested considering as risk factors the occurrence of DQB1 0302 DQB1 0201 alleles, the presence of a neutral amino acid residue in position 57 of the DQ beta chain instead of
aspartic acid
, as well as an arginine residue in position 52 of the DQ alpha chain. With regard to acquired aetiological factors, the hypothesis that primary lesions of pancreatic islets could be due to some viral infections capable of triggering, through several undefined mechanisms, persistent and self-sustaining autoimmune reactions, has gained some credit.
...
PMID:[Current views on the etiopathogenesis of type-I diabetes mellitus]. 821 79
Insulin-dependent diabetes mellitus
(
IDDM
) is strongly associated with particular HLA-DQ alpha/beta markers in white population. The heterodimers conformation composed of a DQ alpha chain with an arginine at residue 52 (Arg52) combined to a DQ beta chain lacking an
aspartic acid
at residue 57 (non Asp57) increase markedly the risk to develop
IDDM
. To confirm this association, 63
IDDM
patients from Santiago de Chile registry, 20
IDDM
patients from Temuco registry and 74 unrelated healthy non diabetic control subjects were studied. With polymerase chain reaction (PCR) and sequence specific oligonucleotide probes the individuals were typed for their HLA-DQA1 and DQB1 alleles, their DQA1/DQB1 genotype and heterodimers conformation were compared. In diabetic population both markers Arg52 homocygote and non Asp57 homocygote were markedly increased regard to control subjects (R/R: 0.76 and 0.85 vs 0.33; ND/ND: 0.78 and 0.75 vs 0.50, p < 0.05). A high relative risk (RR) was determined for both homocygote markers in
IDDM
groups. Arg52 DQ alpha (R)/non Asp57 DQ beta (ND) heterodimers were strongly associated with susceptibility to
IDDM
. A high RR was observed in patients with four susceptibility DQ heterodimers (RR1: 13.7 in
IDDM
-Santiago and RR2: 18.6 in
IDDM
-Temuco, p < 0.00003). The HLA-DQ alpha/beta markers and their risk heterodimers are increased in our diabetic population and could be considered as susceptibility markers to develop
IDDM
.
...
PMID:[Genetic predisposition to develop insulin-dependent diabetes mellitus. A population study in Santiago and Temuco, Chile]. 873 11
MHC associations with
IDDM
in the Korean population were studied to investigate genetic susceptibility to this disorder. The frequencies of HLA-DR3, -DR4 and -DR9 were significantly higher in diabetic patients. However, the frequency of DR2 was significantly decreased in diabetic patients. DQA1*0301 and DQA1*0501 were positively and DQA1*0102 and DQA1*0201 negatively associated with
IDDM
. DQB1*0301 and DQB1*0601 were negatively associated with
IDDM
. Heterodimers DQA1*0301-DQB1*0201, DQA1*0501-DQB1*0201 and DQA1*0501-DQB1*0302 were positively associated with DQA1*0102-DQB1*0601 negatively associated with
IDDM
. The frequencies of DR3-DQA1*0301-DQB1*0201 and -DQA1*0501-DQB1*0201 were significantly higher in diabetic patients. The frequencies of DR4-DQA1*0301-DQB1*0201 and DR9-DQA1*0301-DQB1*0303 were significantly higher in diabetic patients. The presence of non-
aspartic acid
at position 57 of the DQ beta-chain was not associated with susceptibility to
IDDM
. However, the frequency of Arg 52 homozygotes was significantly higher in diabetic patients. These results suggest a role of the MHC molecule and also suggest racial differences in susceptibility to
IDDM
even within the Asian populations.
...
PMID:Role of HLA class II alleles in Korean patients with IDDM. 879 97
The WHO DiaMond Molecular Epidemiology Sub-Project is testing the hypothesis that the geographic differences in
IDDM
incidence reflect population variation in the frequency of
IDDM
susceptibility genes (i.e., DQA1 and DQB1 alleles with sequences coding for arginine (R) in position 52 of the DQ alpha-chain, and an amino acid other than
aspartic acid
(ND) in position 57 of the DQ beta-chain, respectively) using a standardized case-control design. Data from twelve populations which have completed (or have nearly completed) recruitment and HLA molecular analyses are presented. There was an approximate 2-fold increase in the frequencies of DGA1*0301, DQB1*0201 and DQB11*0302 among
IDDM
cases compared to non-diabetic controls in most populations. Interestingly, DQA*0301 was more common in low versus moderate-high incidence countries. DQB1*0201 and DQB1*0302 were more prevalent in the moderate-high incidence areas. DQA1*R and DQB1*ND were both consistent markers of
IDDM
risk, with stronger associations in moderate-high versus low incidence areas. In general, individuals homozygous for both DQA1*R and DQB1*ND had the highest genotype-specific
IDDM
incidence rates, which approximated risk estimates for first degree relatives in several countries. These data revealed considerable variation in the frequencies of DQB1 and DQA1 alleles across countries, which likely contribute to the global patterns of
IDDM
incidence.
...
PMID:Molecular IDDM epidemiology: international studies. WHO DiaMond Molecular Epidemiology Sub-Project Group. 901 79
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