Immunopathological and genetic features in slowly progressive insulin-dependent diabetes mellitus and latent autoimmune diabetes in adults.
In 1982 we proposed the presence of a subtype of type 1 diabetes [slowly progressive insulin-dependent diabetes mellitus (SPIDDM)], which was characterized by persistently positive islet cell antibody, late age of onset, noninsulin-dependent diabetes, and slowly progressive beta cell failure. Since then many studies demonstrated that this subtype of type 1 diabetes is prevalent in many ethnic groups and was later called the latent autoimmune diabetes in adults (LADA). Recent epidemiological studies reported that about 10% of patients with apparent type 2 diabetes have at least one autoantibodies against islet-specific antigen with high potential to progress to insulin-dependent state. Between SPIDDM and LADA some differences are reported in terms of some genetic predispositions including HLA class II and class I genes, vitamin D receptor gene, and CTLA4 genes. Common features in SPIDDM and LADA including preserved beta cells at the onset of diabetes and weak T cell response to residual beta cells suggest that these subtypes of type 1 diabetes are suitable candidates for prevention treatment for further progression of beta cell failure.
Kobayashi
Tetsuro
T
Third Department of Internal Medicine, School of Medicine, University of Yamanashi, Tamaho, Yamanashi 409-3898, Japan. tetsurou@yamanashi.ac.jp
Tanaka
Shoichiro
S
Harii
Norikazu
N
Aida
Kaoru
K
Shimura
Hiroki
H
Ohmori
Masayuki
M
Kanesige
Masahiro
M
Shimada
Akira
A
Maruyama
Taro
T
D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000235:genetics* / Q000276:immunology* / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000145:classification / Q000235:genetics* / Q000276:immunology* / Q000473:pathology; D018450:Disease Progression; D000939:Epitopes; D020022:Genetic Predisposition to Disease; D005968:Glutamate Decarboxylase / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D000949:Histocompatibility Antigens Class II / Q000235:genetics; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D018167:Receptors, Calcitriol / Q000235:genetics; D012307:Risk Factors
D001323:Autoantibodies; D000939:Epitopes; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D018167:Receptors, Calcitriol; C024211:islet cell antibody; D005968:Glutamate Decarboxylase