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Review Article Immunogenetic Heterogeneity of Type 1 Diabetes in Japan


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Title: Review Article Immunogenetic Heterogeneity of Type 1 Diabetes in Japan
Authors: Kawasaki, Eiji / Ide, Akane / Abiru, Norio / Eguchi, Katsumi
Issue Date: 17-Dec-2002
Citation: Acta medica Nagasakiensia. 2002, 47(3-4), p.81-88
Abstract: Type 1 diabetes is an organ-specific autoimmune disease characterized by T-cell mediated destruction of pancreatic ホイ-cells . In Japanese population, the incidence of type 1 diabetes in children is very low compared to European countries. However, there are more patients with type 1 diabetes in adults, including latent autoimmune diabetes in adults (LADA). A variety of environmental and genetic factors are involved in the development of the disease. The human leukocyte antigen (HLA) class II genes (termed IDDM1) are the major genes associated with susceptibility to type 1 diabetes. HLA-DRB1*0405-DQB1*0401, HLA-DRB1* 0901-DQB1*0303 and HLA-DRB1*0802-DQB1*0302 are three major haplotypes in Japanese patients with type 1 diabetes. Other genetic factors reported in Japanese type 1 diabetes include the polymorphisms in insulin gene (IDDM2), CTLA-4 gene (IDDM12), MICA gene, Neuro D/Beta 2 gene, and IL-10 gene. The circulating autoantibodies to multiple islet autoantigens including GAD, insulin, and IA-2 are the important immunological features of type 1 diabetes. The prevalences of anti-islet autoantibodies in patients with Japanese type 1 diabetes are 60-70% for GAD autoantibodies, 45-50% for insulin autoantibodies (IAA), and 60-65% for IA-2 autoantibodies at disease onset, which are similar to those reported in Caucasian patients. With combinatorial analysis of these autoantibodies ninety percent of patients express at least one of these autoantibodies and are classified as immune-mediated type 1 diabetes. Although the majority of patients with type 1 diabetes are young, lean, and ketosisprone, there are number of patients with type 1 diabetes initially diagnosed as having type 2 diabetes at disease onset. These slow-onset diabetic patients with anti-islet autoantibodies often progress toward insulin-deficient state within several years after diagnosis. High level of GAD autoantibodies has a high predictive value for future insulin deficiency in slow-onset patients with type 1 diabetes. In conclusion, Japanese patients with type 1 diabetes are clinically heterogenous and the determination of immunological and genetic features are helpful to clarify the characteristics of the Japanese type 1 diabetic syndrome.
Keywords: type 1 diabetes / autoantibodies / genetics / heterogeneity / immunology / autoantigen
URI: http://hdl.handle.net/10069/16216
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 47, No. 3-4

Citable URI : http://hdl.handle.net/10069/16216

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