Autoantibody "subspecificity" in type 1 diabetes: risk for organ-specific autoimmunity clusters in distinct groups.
OBJECTIVE
Autoimmune thyroid disease (AIT), celiac disease, and Addison's disease are characterized by the presence of autoantibodies: thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in AIT, tissue transglutaminase antibody (TTGAb) in celiac disease, and 21-hydroxylase antibody (21-OHAb) in Addison's disease. The objective of this study was to define the prevalence of these autoantibodies and clinical disease in a population with type 1 diabetes.


METHODS
We screened 814 individuals with type 1 diabetes for TPOAb, TGAb, TTGAb, and 21-OHAb. Clinical disease was defined by chart review. Factors related to the presence of autoimmunity and clinical disease including age at onset of type 1 diabetes, duration of diabetes, age at screening, sex, and the presence of autoantibodies were reviewed.


RESULTS
The most common autoantibodies expressed were TPOAb and/or TGAb (29%), followed by TTGAb (10.1%) and 21-OHAb (1.6%). Specific HLA DR/DQ genotypes were associated with the highest risk for expression of 21-OHAb (DRB1*0404-DQ8, DR3-DQ2) and TTGAb (DR3-DQ2- DR3-DQ2). The expression of thyroid autoantibodies was related to 21-OHAb but not to TTGAb. The presence of autoantibodies was associated with and predictive of disease.


CONCLUSIONS
In this large cohort of individuals with type 1 diabetes, the expression of organ-specific autoantibodies was very high. The grouping of autoantibody expression suggests common factors contributing to the clustering.
Barker
Jennifer M
JM
Barbara Davis Center, University of Colorado Health Sciences Center, 4200 E. 9th Ave., B140, Denver, CO 80262, USA. jennifer.barker@uchsc.edu
Yu
Jeesuk
J
Yu
Liping
L
Wang
Jian
J
Miao
Dongmei
D
Bao
Fei
F
Hoffenberg
Edward
E
Nelson
Jerald C
JC
Gottlieb
Peter A
PA
Rewers
Marian
M
Eisenbarth
George S
GS
D000293:Adolescent; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000276:immunology; D002446:Celiac Disease / Q000097:blood / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology*; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D008297:Male; D009928:Organ Specificity; D015995:Prevalence; D012307:Risk Factors; D013954:Thyroglobulin / Q000276:immunology
D001323:Autoantibodies; D006680:HLA Antigens; D013954:Thyroglobulin; D007453:Iodide Peroxidase