1. Subtyping of Type 1 Diabetes as Classified by Anti-GAD Antibody, IgE Levels, and Tyrosine kinase 2 (TYK2) Promoter Variant in the Japanese
- Author
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Nobutaka Tsutsu, Shiori Kondo, Keiichiro Mine, Kanako Hirakawa, Yasunobu Yoshikai, Keizo Anzai, Fumiko Kojima, Seiho Nagafuchi, Masae Minami, Akira Okada, Yumi Hibio, Hironori Kurisaki, Shuji Fujimoto, and Yasushi Yokogawa
- Subjects
0301 basic medicine ,endocrine system diseases ,lcsh:Medicine ,Type 1 diabetes (T1D) ,medicine.disease_cause ,Immunoglobulin E ,Autoimmunity ,Pathogenesis ,0302 clinical medicine ,Th1/Th2 ,lcsh:R5-920 ,Th2, type 2 T helper ,TYK2, Tyrosine kinase 2 ,T1D, Type 1 diabetes ,YH, young healthy controls ,General Medicine ,Protein-Tyrosine Kinases ,Subtyping ,Tyrosine kinase 2 (TYK2) ,Virus ,Tyrosine kinase 2 ,Anti-GAD Ab, anti-glutamic acid decarboxylase antibody ,IgE ,lcsh:Medicine (General) ,Research Paper ,endocrine system ,030209 endocrinology & metabolism ,Biology ,Antiviral Agents ,General Biochemistry, Genetics and Molecular Biology ,Th1, type 1 T helper ,03 medical and health sciences ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Humans ,TYK2 Kinase ,Type 1 diabetes ,lcsh:R ,nutritional and metabolic diseases ,HIES, hyper-IgE syndrome ,medicine.disease ,OR, odds ratio ,CI, confidence interval ,030104 developmental biology ,Anti-GAD ,Immunology ,biology.protein ,Interferons - Abstract
Objective Type 1 diabetes (T1D) is known to be caused by Th1 cell-dependent autoimmunity. Recently, we reported that TYK2 promoter variant serves as a putative virus-induced diabetes susceptibility gene associated with deteriorated interferon-dependent antiviral response. TYK2 is also related to HIES, that is, Th2 cell-dependent. Therefore, TYK2 promoter variant may be also associated with the pathogenesis of T1D, modulating Th1/Th2 balance. Research Design and Methods We assessed the association between anti- GAD Ab, IgE levels, and TYK2 promoter variant among 313 T1D patients, 184 T2D patients, and 264 YH controls in the Japanese. Results T1D patients had elevated IgE (median, 56.7 U/ml; p, Highlights • T1D can be subtyped into 4 groups based on anti-GAD Ab, IgE levels and TYK2 promoter variant. • Only one subtype, without anti-GAD Ab or elevated IgE, was associated with TYK2 promoter variant and flu-like syndrome. • Profiling of T1D by anti-GAD Ab and IgE levels is useful to realize the variable immuno-pathogenesis of T1D. Since TYK2 gene is associated with T1D and HIES, we assessed the association between anti-GAD Ab, IgE levels, and TYK2 promoter variant in patients with T1D. Consequently, T1D can be subtyped into 4 distinct groups based on these clinical laboratory and genetic markers. Only those patients without anti-GAD Ab or elevated IgE were associated with TYK2 promoter variant and with flu-like syndrome at the diabetes onset, suggestive of association with virus-induced diabetes. This study describes the usefulness of subtyping of T1D with variable immunological bases and provides a clue to delineate the pathogenesis of T1D.
- Published
- 2017