Genetics of fulminant type 1 diabetes
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MINI-REVIEW
Genetics of fulminant type 1 diabetes Yumiko Kawabata1 · Hiroshi Ikegami1 Received: 7 August 2020 / Accepted: 17 September 2020 / Published online: 21 September 2020 © The Japan Diabetes Society 2020
Abstract Since fulminant type 1 diabetes was reported as a distinct subtype of type 1 diabetes in 2000, the Committee on Type 1 diabetes, Japan Diabetes Society has continuously recruited patients and conducted genomic research to elucidate the genetic basis of fulminant type 1 diabetes. The contribution of the human leukocyte antigen complex (HLA) to genetic susceptibility to fulminant type 1 diabetes was compared with that of other subtypes in 2009. The alleles and haplotypes associated with fulminant type 1 diabetes were found to be different from acute-onset and slowly progressive type 1 diabetes. DRB1*15:01-DQB1*06:02, a protective haplotype against acute-onset type 1 diabetes, does not provide protection against fulminant type 1 diabetes and DRB1*08:02-DQB1*03:02, a susceptible haplotype to acute-onset type 1 diabetes, does not confer susceptibility to fulminant type 1 diabetes. Recently, the first genome-wide association study (GWAS) of fulminant type 1 diabetes was performed in Japanese individuals. A strong association was observed with multiple single nucleotide polymorphisms (SNPs) in the HLA region, and the strongest association was observed with rs9268853 in the class II DR region. In addition, 11 SNPs outside the HLA region showed some evidence of association with the disease. In particular, rs11170445 in CSAD/lnc-ITGB7-1 on chromosome 12q13.13 showed an association at a genome-wide significance level. Fine mapping revealed that rs3782151 in CSAD/lnc-ITGB7-1 showed the lowest P value. CSAD/lnc-ITGB7-1 was found to be strongly associated with susceptibility to fulminant, but not classical, autoimmune type 1 diabetes, implicating this locus in the distinct phenotype of fulminant type 1 diabetes. Keywords Genetics · Fulminant type 1 diabetes · Genome-wide association study (GWAS) · Human leukocyte antigen (HLA) · Cysteine sulfinic acid decarboxylase (CSAD) · Integrin subunit beta 7 (ITGB7)
Introduction Since the first report on fulminant type 1 diabetes in 2000 [1], continuous effort led by the Committee on Type 1 diabetes, Japan Diabetes Society, revealed genetics, etiology and pathogenesis of fulminant type 1 diabetes. This review discusses recent progress in the genetics of fulminant type 1 diabetes in comparison with that of classical autoimmune type 1 diabetes. Type 1 diabetes is a multifactorial disease caused by the destruction of insulin-producing β cells of the pancreas. The resulting absolute insulin deficiency requires exogenous insulin for survival, and long-term complications can * Yumiko Kawabata [email protected] 1
Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, 377‑2 Ohno‑higashi, Osaka‑sayama, Osaka 589‑8511, Japan
disturb quality of life and shorten life span. Most cases of type 1 diabetes are thought to be of autoim
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