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Query: UMLS:C0011854 (
type 1 diabetes
)
20,749
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Insulin-dependent diabetes mellitus
(
IDDM
) is an autoimmune disease that results in the destruction of the pancreatic islet beta cells.
Glutamic acid decarboxylase
(
GAD
) has been recently indicated as a key autoantigen in the induction of
IDDM
in nonobese diabetic mice. In human diabetes, the mechanism by which the beta cells are destroyed is still unknown. Here we report the first evidence for the presence of
GAD
-specific cytotoxic T cells in asymptomatic and recent diabetic patients. GAD65 peptides displaying the human histocompatibility leukocyte antigen (HLA)-A*0201 binding motif have been synthesized. One of these peptides, GAD114-123, binds to HLA-A*0201 molecules in an HLA assembly assay. Peripheral blood mononuclear cells from individuals with preclinical
IDDM
, recent-onset
IDDM
, and from healthy controls were stimulated in vitro with the selected peptide in the presence of autologous antigen-presenting cells. In three cases (one preclinical
IDDM
and two recent-onset
IDDM
), we detected specific killing of autologous antigen-presenting cells when incubated with GAD114-123 peptide or when infected with a recombinant vaccinia virus expressing GAD65. These patients were the only three carrying the HLA-A*0201 allele among the subjects studied. Our finding suggests that
GAD
-specific cytotoxic T lymphocytes may play a critical role in the initial events of
IDDM
.
...
PMID:Cytotoxic T cells specific for glutamic acid decarboxylase in autoimmune diabetes. 772 68
Glutamic acid decarboxylase
antibodies (GAD65Ab) are common in new onset Caucasian insulin-dependent diabetic (
IDDM
) patients but it is unclear if this marker is also prevalent in patients of other ethnic backgrounds. We determined antibodies against human recombinant GAD in Japanese diabetic patients using a radioimmunoassay with competition between in vitro translated 35S-GAD65 and non-labelled recombinant human GAD65 (rhGAD65). GAD67 antibodies (GAD67Ab) were similarly analyzed but without antigen competition. In 73 Japanese diabetic patients, GAD65Ab were found in 11/16 (69%) of patients with short-duration (less than 5 yrs)
IDDM
, 6/23 (26%) with long-duration (5 or more yrs)
IDDM
and 10/20 (50%) with slowly progressive diabetes. High GAD65Ab levels were associated with concomitant autoimmune diseases (p = 0.021). GAD67Ab were found in 4/16 (25%) of patients with short-duration
IDDM
, 3/23 (13%) with long-duration
IDDM
and 2/20 (10%) with slowly progressive diabetes. In 14 non-insulin dependent diabetic (NIDDM) patients, GAD65Ab and GAD67Ab were not found (0/14) and 1/50 (2%) healthy controls were positive in either assay. Among the GAD67Ab-positive samples, 8/9 (88%) were also high level GAD65Ab positive, 7/9 (77%) were displaced by an excess of rhGAD65 and the antibody levels correlated (r2 = 0.573; p = 0.003). Our data are consistent with a strong association of GAD65Ab also in Japanese
IDDM
, and suggest that, when present, GAD67Ab are frequently directed to epitope(s) common to GAD65 and GAD67.
...
PMID:Radioimmunoassay detects the frequent occurrence of autoantibodies to the Mr 65,000 isoform of glutamic acid decarboxylase in Japanese insulin-dependent diabetes. 777 1
Glutamic acid decarboxylase
autoantibodies may aid in rapid screening strategies predicting
IDDM
before clinical onset. Rat islets contain GAD65 and GAD67 autoantibody targets, but human islets express only GAD65, now confirmed by direct immunoprecipitation from radiolabeled rat and human islets. Because human
IDDM
involves beta-cell-specific autoimmunity, we tested 190 new
IDDM
patients and 51 healthy control subjects for antibodies to recombinant human islet GAD65, rat islet GAD67, or human insulinoma/cerebellum GAD67, each expressed separately in hamster fibroblasts. By using immunoprecipitation, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and densitometric fluorogram scanning, 132 of 190 (70%) of new
IDDM
patients had GAD65 autoantibodies, whereas only 17 of 190 (9%) had antibodies to rat GAD67 (P < 0.001). Of healthy control subjects, 2 of 51 (3.9%) and 1 of 51 (1.9%) had antibodies to GAD65 and GAD67, respectively. All 17 GAD67 antibody-positive patients also had GAD65 antibodies; 14 of 17 with greater GAD65 than GAD67 index. Control studies showed comparable reactivity between recombinant rat and human GAD67 and between different subcellular preparations of recombinant GAD67 of either species. In conclusion, only GAD65 is expressed in human islets, the autoantibody response is primarily to this isoform, and GAD67 antibodies add little to
IDDM
detection.
...
PMID:Autoantibodies in IDDM primarily recognize the 65,000-M(r) rather than the 67,000-M(r) isoform of glutamic acid decarboxylase. 845 15
Glutamic acid decarboxylase
(
GAD
) catalyzes formation of gamma-aminobutyric acid from glutamic acid and is a major autoantigen in insulin-dependent diabetes mellitus. Its two isoforms, GAD65 and GAD67, are encoded by two separate genes. We prepared human islet cDNA library and screened it with cDNA probes of rat brain GAD67. We cloned the cDNA for GAD67, the large isoform of glutamic acid decarboxylase, and determined its nucleotide sequence. Sequencing of the resulting clone identified a 1,785 residue open-reading frame encoded a 594 amino acid polypeptide that showed a 99.4% similarity with GAD67 from human brain. The bacterially expressed human islet GAD67 protein was enzymatically active and immunoreactive. The isolation of cDNA for this additional islet
GAD
isoforms will be important in studying the etiology and pathogenesis of
IDDM
.
...
PMID:Cloning and expression of large isoform of glutamic acid decarboxylase from human pancreatic islet. 850 3
NOD mice constitute a model for studying the prevention of human autoimmune
type 1 diabetes
.
Glutamic acid decarboxylase
(
GAD
) could be a key antigen involved in this disease, and GAD65 peptide 524-543 has been implicated in early T cell response in young NOD mice. We performed two i.p. injections of
GAD
peptide 524-543 (100 micrograms at each injection), together with Freund's incomplete adjuvant (FIA), into female NOD mice at 30 and 45 days old. Diabetes was accelerated 2 weeks later by a single injection of cyclophosphamide (CY), which acts against suppressive mechanisms. Treatment with
GAD
524-543 peptide delayed the onset of diabetes and reduced its incidence (28% versus 60%; P < 0.001) compared with control mice injected with FIA alone, or
GAD
peptide 534-553, or an irrelevant peptide. In the same group, the severity of lymphocytic inflammation of pancreatic islets was reduced (P < 0.03). Up to 3 months after peptide injections, a strong splenocytic proliferative response occurred in immunized NOD mice against the immunizing peptide alone (but not against a panel of seven other GAD65-derived peptides). After peptide challenge of splenocytes in vitro, protection against CY-accelerated diabetes was associated with higher peptide-specific production of T helper type 2 (Th2)-associated interleukins 4 and 10, whereas Th1-associated interferon-gamma and IL-2 were proportionally less represented. During contransfer, T splenocytes from
GAD
524-543-immunized mice were able to reduce the capacity of T cells from diabetic donors to transfer the disease adoptively (P < 0.01), demonstrating the generation of cellular mechanisms that actively suppress the disease. It is concluded that immunization of NOD mice with GAD65 peptide 524-543 can counteract CY-accelerated diabetes, possibly through active cellular suppression linked to a shift of Th1/Th2 balance toward the production of Th2 cytokines such as IL-4 and IL-10. This study provides additional support for the notion that
GAD
, and more precisely its epitope 524-543, could be one of the key targets for the pathogenesis of
type 1 diabetes
in NOD mice, as well as for the efficacy of disease-specific peptide therapy in
type 1 diabetes
.
...
PMID:Immunization of non-obese diabetic (NOD) mice with glutamic acid decarboxylase-derived peptide 524-543 reduces cyclophosphamide-accelerated diabetes. 870 42
Insulin-dependent diabetes (
IDDM
) is probably mediated by T lymphocytes recognizing critical beta cell autoantigens.
Glutamic acid decarboxylase
(
GAD
) 65 is a major antigen in
IDDM
. T cells in both
IDDM
patients and controls respond to
GAD
65 and certain epitopes of this molecule. To clarify the immune response to
GAD
65 we established T cell clones specifically recognizing epitopes of
GAD
65. We obtained T cells clones to
GAD
65 peptides 161-175 (from a healthy individual), and 505-519 and 521-535 (from two
IDDM
patients). On extensive screening T cells responsive to peptide 161-175 were found only in controls, while T cells responsive to peptide 521-535 were found only in
IDDM
patients; T cells from both
IDDM
patients and controls responded to peptide 505-519. We could exclude simple genetic shaping of these T cell responses since the responses differed between genetically identical twins discordant for
IDDM
. Reactivity of T cell clones from the control to peptide 161-175 was restricted by HLA DR1 but promiscuous for HLA DR4 as DR4+ EBV transformed B cells and DR4+ mouse L-transfectants could present the peptide. As DR4+ antigen presenting cells of diabetics could present peptide 161-175 to some clones, the lack of response to this epitope in diabetic patients cannot be due to inadequate antigen presentation but is probably due to deletion of these cells either centrally or peripherally. Reactivity of clones to peptide 505-519 was either HLA DR1 or DQ1 restricted. In conclusion, T cell clones to specific epitopes of
GAD
65 provide a model to clarify those differences in the immune response to this autoantigen between controls and
IDDM
patients.
...
PMID:T cell clones to epitopes of glutamic acid decarboxylase 65 raised from normal subjects and patients with insulin-dependent diabetes. 881 75
Glutamic acid decarboxylase
(
GAD
) is one of the major autoantigens found in insulin-dependent (Type 1) diabetes mellitus (
IDDM
). A novel hybrid form of
GAD
was created by fusing amino acids 1-101 of the human GAD67 protein to amino acids 96-585 of the human GAD65 protein. This hybrid GAD67/65 was expressed constitutively under the control of the phosphoglycerate kinase promoter (PGK1) in the yeast Saccharomyces cerevisiae. Enzymatically active
GAD
was prepared from yeast lysates by a one-step purification on an affinity column using
GAD
-1 antibody. The purified hybrid GAD67/65 was radiolabelled with iodine-125 and tested in an immunoprecipitation assay with
IDDM
sera. Results obtained using the recombinant yeast hybrid GAD67/65 were very similar to those obtained using 125I-labelled porcine
GAD
. Recombinant yeast hybrid GAD67/65 should have utility for diagnosis and presymptomatic detection of
IDDM
.
...
PMID:Expression in Saccharomyces cerevisiae of antigenically and enzymatically active recombinant glutamic acid decarboxylase. 965 Feb 86
Glutamic acid decarboxylase
(
GAD
) is a pancreatic beta cell autoantigen in humans and nonobese diabetic (NOD) mice. beta Cell-specific suppression of
GAD
expression in two lines of antisense
GAD
transgenic NOD mice prevented autoimmune diabetes, whereas persistent
GAD
expression in the beta cells in the other four lines of antisense
GAD
transgenic NOD mice resulted in diabetes, similar to that seen in transgene-negative NOD mice. Complete suppression of beta cell
GAD
expression blocked the generation of diabetogenic T cells and protected islet grafts from autoimmune injury. Thus, beta cell-specific
GAD
expression is required for the development of autoimmune diabetes in NOD mice, and modulation of
GAD
might, therefore, have therapeutic value in
type 1 diabetes
.
...
PMID:Control of autoimmune diabetes in NOD mice by GAD expression or suppression in beta cells. 1036 47
Glutamic acid decarboxylase
65 (GAD65) is one of the major autoantigens in
type 1 diabetes
. We investigated whether there is variation in the processing of GAD65 epitopes between individuals with similar HLA backgrounds and whether the processing characteristics of certain immunogenic epitopes are different in distinct APC subpopulations. Using DR401-restricted T cell hybridomas specific for two immunogenic GAD65 epitopes (115-127 and 274-286), we demonstrate an epitope-specific presentation pattern in human B-lymphoblastoid cell lines (B-LCL). When pulsed with the GAD protein, some DRB1*0401-positive B-LCL, which presented GAD65 274-286 epitope efficiently, were unable to present the GAD65 115-127 epitope. However, all B-LCL presented synthetic peptides corresponding to either GAD epitope. In addition, when pulsed with human serum albumin, all cell lines gave equal stimulation of a DR4-restricted human serum albumin-specific T hybridoma. GAD65-transfected cell lines displayed the same presentation phenotype, showing that lack of the presentation of the 115-127 epitope was not due to inefficient uptake of the protein. Blood mononuclear adherent cells, B cells, or dendritic cells derived from the same individual displayed the same presentation pattern as observed in B cell lines, suggesting that the defect most likely is genetically determined. Therefore, individual differences in Ag processing may result in the presentation of distinct set of peptides derived from an autoantigen such as GAD65. This may be an important mechanism for the deviation of the immune response either into a regulatory pathway or into an inflammatory autoimmune reactivity.
...
PMID:Differential presentation of glutamic acid decarboxylase 65 (GAD65) T cell epitopes among HLA-DRB1*0401-positive individuals. 1041 74
Cystic fibrosis-related diabetes mellitus (CF-DM) is thought to be secondary to beta-cell destruction by fibrous tissue replacing the exocrine pancreas. The aim of this study was to investigate the hypothesis that other factors may also be responsible.
Glutamic acid decarboxylase
(
GAD
) and islet cell (IA-2) antibodies were measured by quantitative ELISA in a group of patients with CF (n=30) in comparison to a group of newly diagnosed DM type 1 (
IDDM
) patients (n=30) and normal subjects (n=30).
GAD
antibodies were positive (>32 ng/ml) in 50% of the CF, 93% of the
IDDM
and 0% of the control group. IA-2 antibodies were detected (>0.9 U/ml) in 40% of the CF, 93% of the
IDDM
and 0% of the control group. Among the fifteen CF patients with positive
GAD
and IA-2 antibodies, four already had
IDDM
and another five abnormally low (<45 mU/l) first phase insulin response (FPIR) indicating a prediabetic state. We conclude that factors other than mechanical may be involved in the development of CFDM. The presence of autoantibodies predicting
IDDM
supports the hypothesis that CF-DM may have a multifactorial pathogenesis.
...
PMID:Islet autoantibodies and insulin dependent diabetes mellitus in cystic fibrosis. 1071 59
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