Critical Amino Acid Variants in HLA-DRB1 and -DQB1 Allotypes in the Development of Classical Type 1 Diabetes and Latent Autoimmune Diabetes in Adults in the Japanese Population
by
, ,
Masahito Katahira
1,2,*
,
Taku Tsunekawa
2,
Akira Mizoguchi
2,
Mariko Yamaguchi
2,
Kahori Tsuru
2,
Hiromi Takashima
2 and
Ryoma Terada
2 1
Nursing and Health, Aichi Prefectural University School of Nursing and Health, Togoku, Kamishidami, Moriyama-ku, Nagoya 463-8502, Japan
2
Department of Endocrinology and Diabetes, Ichinomiya Municipal Hospital, 2-2-22, Bunkyo, Ichinomiya 491-8558, Japan
*
Author to whom correspondence should be addressed.
Curr. Issues Mol. Biol. 2021, 43(1), 107-115; https://doi.org/10.3390/cimb43010009
Submission received: 13 April 2021
/
Revised: 4 May 2021
/
Accepted: 7 May 2021
/
Published: 9 May 2021
(This article belongs to the Section Bioinformatics and Systems Biology)
Abstract
:The effects of amino acid variants encoded by the human leukocyte antigen (HLA) class II on the development of classical type 1 diabetes (T1D) and latent autoimmune diabetes in adults (LADA) have not been fully elucidated. We retrospectively investigated the HLA-DRB1 and -DQB1 genes of 72 patients with classical T1D and 102 patients with LADA in the Japanese population and compared the frequencies of HLA-DRB1 and -DQB1 alleles between these patients and the Japanese populations previously reported by another institution. We also performed a blind association analysis with all amino acid positions in classical T1D and LADA, and compared the associations of HLA-DRB1 and -DQB1 amino acid positions in classical T1D and LADA. The frequency of DRß-Phe-13 was significantly higher and those of DRß-Arg-13 and DQß-Gly-70 were significantly lower in patients with classical T1D and LADA than in controls. The frequencies of DRß-His-13 and DQß-Glu-70 were significantly higher in classical T1D patients than in controls. The frequency of DRß-Ser-13 was significantly lower and that of DQß-Arg-70 was significantly higher in LADA patients than in controls. HLA-DRß1 position 13 and HLA-DQß1 position 70 could be critical amino acid positions in the development of classical T1D and LADA.
1. Introduction
Type 1 diabetes (T1D) has three prevalent subtypes: acute-onset (classical), slow-onset, and fulminant T1D [1]. Slow-onset T1D, which develops after the age of 30, is commonly referred to as latent autoimmune diabetes in adults (LADA) [2,3]. Although LADA and fulminant T1D, as well as classical T1D, are associated with human leukocyte antigen (HLA) class II genes, the HLA class II genes that affect the onset of T1D depend on T1D subtype and ethnic group [4,5,6]. In Caucasian populations, HLA-DRB1*03-DQB1*02:01 and -DRB1*04-DQB1*03:02 haplotypes are associated with the highest risk of classical T1D [6] and LADA [4]. Moreover, the existence of DQα-Arg-52 and the absence of DQβ-Asp-57 confer susceptibility to classical T1D [7,8]. Because HLA-DRB1*03-DQB1*02:01 and -DRB1*04-DQB1*03:02 haplotypes are rarely observed in Japanese populations [2,9], it is necessary to investigate T1D susceptibility conferred by HLA class II genes other than HLA-DRB1*03-DQB1*02:01 and -DRB1*04-DQB1*03:02 haplotypes.
We previously demonstrated that HLA-DRB1*04:05-DQB1*04:01, -DRB1*08:02-DQB1*03:02, -DRB1*09:01-DQB1*03:03, and -DRB1*13:02-DQB1*06:04 haplotypes confer susceptibility to classical T1D, and HLA-DRB1*08:02-DQB1*03:02 and -DRB1*09:01-DQB1*03:03 haplotypes confer susceptibility to slow-onset T1D in the Japanese population [2]. However, the role of critical amino acid variants in HLA-DRB1 and -DQB1 alleles in the onset of LADA, such as DQα-Arg-52 and DQβ-Asp-57 in classical T1D, are not fully elucidated. We investigated the HLA-DRB1 and -DQB1 genes in Japanese classical T1D and LADA patients by comparing their allele frequencies with those of controls who were representative of the healthy Japanese population. We also investigated the effects of polymorphic amino acid residue variations in HLA-DRB1 and -DQB1 alleles on the onset of classical T1D and LADA.
2. Materials and Methods
2.1. Study Participants
This is a retrospective study. We identified 185 unrelated Japanese patients with classical (n = 72) and slow-onset (n = 113) T1D who visited the internal medicine departments of participating hospitals between 2001 and 2010. The participating hospitals were Ichinomiya Municipal Hospital (Ichinomiya, Japan), Kyoritsu General Hospital (Nagoya, Japan), and Okazaki City Hospital (Okazaki, Japan), all in the Aichi Prefecture. All patients fulfilled the World Health Organization criteria for diabetes [10]; we have reported some of their clinical and immunogenetic characteristics [2,11]. We excluded 11 patients with slow-onset T1D whose onset of diabetes occurred at age <30 years. Thus, 72 unrelated patients with classical T1D and 102 unrelated patients with slow-onset T1D comprised the final classical T1D and LADA cohort.
These frequencies of HLA-DRB1 and -DQB1 alleles were compared with those of other Japanese populations, as reported by the Japanese Society of Histocompatibility and Immunogenetics [2,9]. This study was approved by the Ethics Committee of Aichi Prefectural University (approval code: 1-43, 26 February 2021) and was conducted in accordance with the Declaration of Helsinki.
2.2. Measurements
The titers of glutamic acid decarboxylase (GAD) antibody (GAD-Ab) and insulinoma-associated antigen-2 antibody (IA-2Ab) were determined as described previously [12]. The cutoff values for GAD-Ab and IA-2Ab were 1.5 and 0.4 U/mL, respectively. Urinary and serum C-peptide levels were determined using a commercially available enzyme immunoassay kit (Eiken C-Peptide Kit; Eiken Chemical, Tokyo, Japan).
HLA-DRB1 sequence-based typing (SBT) was performed by directly sequencing DRB1 exon 2 using the AlleleSEQR DRB1 Typing Kit (Atria Genetics, San Francisco, CA, USA) according to the manufacturer’s instructions, as described previously [2]. HLA-DQB1 SBT was carried out by direct sequencing of DQB1 exon 2 and 3 using the AlleleSEQR DQB1 Typing Kit (Atria Genetics) according to the manufacturer’s instructions, as described previously [2]. Ambiguous genotyping samples were identified using high-resolution polymerase chain reaction-sequence-specific amplification and heterozygous ambiguity resolution primer’s methods. The BIGDAWG software, version 2.5, implemented as the bigdawg R package (GitHub, San Francisco, CA, USA) [13], was used for the analysis of amino acids encoded by the HLA-DRB1 and -DQB1 alleles.
2.3. Statistical Analysis
Study results are presented as means ± standard deviation or percentages with numbers. SPSS 26.0 software (IBM Corp., Armonk, NY, USA) was used for statistical analyses. Chi-square tests based on 2 × 2 contingency tables and Fisher’s exact probability tests were used to compare allele frequencies. p values were corrected for the number of different alleles tested using the Benjamini–Hochberg method (denoted as Pc) [14]. Pc < 0.05 was considered statistically significant.
3. Results and Discussion
3.1. Clinical Data
The median age of patients with classical T1D (29 men and 43 women) was 30 years (range 5–81) at the onset of diabetes. The duration of diabetes and body mass index (BMI) were 9.8 ± 9.9 years and 20.6 ± 3.3 kg/m2, respectively. The positive GAD-Ab and IA-2Ab rates were 60.9% and 42.9%, respectively; 21 classical T1D patients (29.2%) had no positive results for GAD-Ab or IA-2Ab. Urinary and serum 2-h C-peptide levels were 2.6 ± 3.5 nmol/day and 0.15 ± 0.24 nmol/L, respectively. All classical T1D patients were treated with insulin and insulin dosage was 0.69 ± 0.30 U/kg/day.
The median age of patients with LADA (55 men and 47 women) was 52 years (range 31–80) at the onset of diabetes. The duration of diabetes and BMI were 9.5 ± 8.7 years and 23.1 ± 4.3 kg/m2, respectively. The positive GAD-Ab rate was 100%. Urinary and serum 2-h C-peptide levels were 10.8 ± 12.8 nmol/day and 0.92 ± 0.96 nmol/L, respectively. The rate of LADA patients treated with insulin was 69.6% and insulin dosage was 0.50 ± 0.25 U/kg/day.
3.2. HLA-DRB1 and -DQB1 Allele Frequencies in Patients with Classical T1D and LADA
We identified 18 HLA-DRB1 alleles and 11 HLA-DQB1 alleles in patients with classical T1D and 23 HLA-DRB1 alleles and 12 HLA-DQB1 alleles in patients with LADA. The HLA-DRB1 and -DQB1 allele frequencies in patients with classical T1D, those with LADA, and controls are presented in Table 1. However, HLA-DRB1 and -DQB1 alleles with less than a total of five frequencies in patients with classical T1D, those with LADA, and controls were excluded from the comparison of frequencies.
We previously demonstrated that HLA-DRB1*04:05-DQB1*04:01, -DRB1*08:02-DQB1*03:02, -DRB1*09:01-DQB1*03:03, and -DRB1*13:02-DQB1*06:04 haplotypes confer susceptibility to classical T1D in the Japanese population [2]. Of these alleles, only HLA-DQB1*03:02 allele was not associated with classical T1D in the present study. In Caucasian populations, the HLA-QB1*03:02 allele constitutes the HLA-DRB1*04-DQA1*03:01-DQB1*0302 haplotype, which confers susceptibility to classical T1D [5]. In the Japanese population, this haplotype is rare, but the HLA-DQB1*03:02 allele constitutes the haplotype with HLA-DRB1*08:02 and -DQA1*03:01 alleles, which has Arg at HLA DQα1 position 52 that confers susceptibility to classical T1D [8]. The HLA-DQA1 allele, rather than the HLA-DRB1 and -DQB1 alleles, might play an important role in the development of classical T1D in this haplotype. HLA-DRB1*11:01, -DRB1*14:05, -DRB1*15:01, -DRB1*15:02, -DQB1*03:01, -DQB1*05:03, -DQB1*06:01, and -DQB1*06:02 alleles were found to confer protection against classical T1D in this study. These alleles constitute HLA-DRB1-DQB1 haplotypes in the Japanese population, i.e., HLA-DRB1*11:01-DQB1*03:01, -DRB1*14:05-DQB1*05:03, -DRB1*15:01-DQB1*06:02, and -DRB1*15:02-DQB1*06:01 [2,9]. The above findings are consistent with previous studies [2,6].
We previously demonstrated that HLA-DRB1*04:07-DQB1*03:02, -DRB1*08:02-DQB1*03:02, and -DRB1*09:01-DQB1*03:03 haplotypes confer susceptibility to slow-onset T1D in the Japanese population [2,11]. Of these alleles, we found that only the HLA-DRB1*08:02 allele was not associated with LADA. The HLA-DRB1*08:02-DQB1*03:02 haplotype shares the same HLA-DQB1 allele with the HLA-DRB1*04:07-DQB1*03:02 haplotype. The HLA-DQB1*03:02 allele might play an important role in the development of LADA in these haplotypes. We found that the HLA-DRB1*15:01 and -DQB1*06:02 alleles confer protection against LADA. These alleles constitute the HLA-DRB1-DQB1 haplotype [2,9] and the above findings are consistent with previous studies [2,11].
3.3. Polymorphic DRB1 and DQB1 Amino Acid Residue Variations in Patients with Classical T1D and LADA
To elucidate why HLA-DRB1 and -DQB1 alleles differentially contribute to the development of classical T1D and LADA, we examined the amino acid variants in HLA-DRB1 and -DQB1 allotypes. We performed a blind association analysis of all amino acid positions in classical T1D and LADA using Bridging ImmunoGenomic Data-Analysis Workflow Gaps (BIGDAWG) software and compared the associations of different amino acid positions in classical T1D and LADA. Since the cohort of this study was not very large and belonged to the same ethnic group, we did not use a deep learning method for HLA imputation [15]. On analysis, we identified 21 amino acid positions associated with classical T1D (DRß6, DRß13, DRß21, DRß31, DRß33, DRß39, DRß55, DRß68, DRß77, DQß15, DQß22, DQß29, DQß30, DQß31, DQß32, DQß34, DQß35, DQß61, DQß70, DQß75, and DQß85; p = 2.4 × 10−10, 3.4 × 10−4, 3.6 × 10−11, 6.8 × 10−8, 7.9 × 10−7, 7.9 × 10−7, 0.0268, 1.0 × 10−8, 1.0 × 10−8, 1.6 × 10−8, 0.0189, 4.7 × 10−5, 4.7 × 10−5, 2.9 × 10−14, 3.7 × 10−9, 4.7 × 10−5, 4.7 × 10−5, 0.0170, 1.2 × 10−4, 4.2 × 10−6, and 4.6 × 10−5, respectively), and 17 amino acid positions associated with LADA (DRß6, DRß13, DRß21, DRß31, DRß33, DRß39, DRß68, DRß77, DQß15, DQß29, DQß30, DQß31, DQß32, DQß34, DQß35, DQß70, and DQß85; p = 0.0317, 0.0012, 1.8 × 10−4, 0.0110, 2.3 × 10−4, 2.3 × 10−4, 0.0025, 0.0025, 0.0020, 5.8 × 10−4, 5.8 × 10−4, 6.6 × 10−4, 0.0012, 5.8 × 10−4, 5.8 × 10−4, 0.0020, and 2.9 × 10−4, respectively). Of these residues, the amino acids at HLA-DRß1 positions 13, 31, and 33 and at HLA-DQß1 positions 30, 70, 75, and 85 had variants in the HLA-DRB1 and -DQB1 alleles that we examined in this study. Thus, we compared the frequencies of the amino acids at HLA-DRß1 positions 13, 31, and 33 and at HLA-DQß1 positions 30, 70, 75, and 85 between classical T1D and controls, and at HLA-DRß1 positions 13, 31, and 33 and at HLA-DQß1 positions 30, 70, and 85 between LADA and controls.
The HLA-DRB1 and -DQB1 amino acid variants at DR and DQ positions that showed a strong association with classical T1D and LADA are presented in Table 2. Table 3 shows HLA-DRB1 amino acid variants at positions 13, 31, and 33, and HLA-DQB1 amino acid variants at positions 70 and 85, which confer susceptibility to or protection against classical T1D or LADA. DRß-Phe-31, DRß-Asn-33, and DQß-Val-85, which confer protection against classical T1D, are encoded by alleles which were found to confer susceptibility to or protection against the disease in the present study. Classical T1D-susceptible DQß-Leu-85 and LADA-protective DRß-Phe-31 are encoded by alleles which were found to confer susceptibility to or protection against the diseases in the present study. These amino acid variants might not be involved in the onset of the diseases. As a result, HLA-DRß1 position 13 and HLA-DQß1 positions 70 and 85 could be critical amino acid positions in the development of classical T1D and LADA.
Hu et al. demonstrated that conditioning on HLA-DQβ1 position 57, the second independent association with classical T1D was at HLA-DRß1 position 13 in Caucasian populations [16]. At this position, His and Ser conferred the strongest risk, whereas Arg and Tyr were protective. DRß-Ser-13 and DRß-Tyr-13 are respectively encoded by the HLA-DRB1*03:01 and -DRB1*07:01 alleles, which are rare in the Japanese population [2,9]. On the other hand, the HLA-DRB1*09:01 allele, which encodes Phe at HLA-DRß1 position 13 (Table 3), confer weak susceptibility to classical T1D in Caucasian populations [6]. Gerasimou et al. recently demonstrated that DQß-Arg-70 and DQß-Gly-70, respectively, confer susceptibility to and protection against classical T1D in Caucasian populations [17]. DQß-Arg-70 is encoded by the HLA-DQB1*02:01 allele, which is rare in Japanese populations [2,9]. DQß-Glu-70 is encoded by the HLA-DQB1*04:01 allele (Table 3), which is rare in Caucasian populations [6].
To the best of our knowledge, there is no report investigating the association of LADA with the amino acid variants in HLA-DRB1 and -DQB1 allotypes. The existence of DQα-Arg-52 and the absence of DQβ-Asp-57 did not confer susceptibility to LADA, as shown in classical T1D [18]. In the present study, DRß-Phe-13 encoded by the HLA-DRB1*09:01 allele and DRß-Arg-13 encoded by the HLA-DRB1*15:01 allele, respectively, confer susceptibility to and protection against LADA. Previous studies demonstrated that the HLA-DRB1*09 allele confers susceptibility to LADA in Asians [2,11,18,19], but not Caucasians [19,20]. The HLA-DRB1*15 allele confer protection against LADA both in Asians [2,11] and in Caucasians [20]. Although DRß-Ser-13 is not encoded by alleles, which confer susceptibility to and protection against LADA in the present study, it confers protection against LADA. DRß-Ser-13 is encoded by the HLA-DRB1*03:01 allele, which confers susceptibility to LADA in Caucasians [19,20] and in Asians other than the Japanese [18,19]. DRß-Ser-13 is also encoded by the HLA-DRB1*11:01 and -DRB1*14 alleles, which were found to have a protective trend against LADA in the present study and the previous study [19]. Desai et al. demonstrated that the HLA-DRB1*11:01 allele confers protection against LADA in Caucasians [20].
In the present study, DQß-Arg-70 and DQß-Leu-85 encoded by HLA-DQB1*03:02 and -DQB1*03:03 alleles, respectively, confer susceptibility to LADA. Previous reports demonstrated that the HLA-DQB1*03:02 allele, which constitutes the HLA-DRB1*04-DQA1*03:01-DQB1*03:02 haplotype in Caucasian populations, confers susceptibility to LADA, as well as to classical T1D [20,21,22,23,24]. On the other hand, the effect of the HLA-DQB1*03:03 allele on LADA is controversial. Previous reports demonstrated that this allele confers susceptibility to LADA in Asians [4,25]. However, another report demonstrated that this allele confers protection against LADA in Caucasian populations [19]. The HLA-DQB1*03:03 allele constitutes the HLA-DRB1*09-DQB1*03:03 haplotype. As with the HLA-DRB1*09:01 allele, the effect of the HLA-DQB1*03:03 allele on LADA depends on the ethnic group. Previous reports demonstrated that the HLA-DQB1*06:02 allele, which encodes DQß-Gly-70 and DQß-Val-85, confers protection against LADA [20,24,26]. However, the protective effect of this allele on LADA was not as strong as that on classical T1D [26,27]. Taken together, the protective effect of DQß-Gly-70 and DQß-Val-85 on LADA might be limited.
There are several limitations in this study. First, we were unable to demonstrate the association of DQβ-Asp-57 with classical T1D. Although the HLA-DQB1*0601 and -DQB1*06:02 alleles, which encode DQβ-Asp-57, were found to confer protection against classical T1D in the present study, a blind association analysis did not detect the association of HLA-DRβ1 position 57 with classical T1D. However, previous studies demonstrated that DQβ-Asp-57 did not confer protection against classical T1D, neither in Asians [28,29,30,31,32,33] nor in Caucasians [34,35]. In addition, we did not analyze HLA-DQA1 alleles, HLA-DP loci, or HLA class I alleles. Recently, Xia et al. demonstrated that HLA-DP loci are associated with classical T1D [36]. Mishra et al. demonstrated that the HLA class I association may be a genetic discriminator between LADA and classical T1D [37]. We could not exclude the primary role of these loci in the development of classical T1D and LADA.
4. Conclusions
HLA-DRβ1 position 13 and HLA-DQß1 position 70 could be critical amino acid positions in the development of classical T1D and LADA. DRß-Phe-13 confers susceptibility to classical T1D and LADA, and DRß-Arg-13 and DQß-Gly-70 confer protection against the diseases. In addition, DRß-His-13 and DQß-Glu-70 confer susceptibility to classical T1D, and DRß-Ser-13 and DQß-Arg-70 confer protection against and susceptibility to LADA, respectively. Such novel alleles could guide autoantigen discovery and tolerance immunotherapies. Further studies are required to determine the underlying mechanisms of these differences.
Author Contributions
Conceptualization, M.K. and T.T.; methodology, A.M.; software, R.T.; validation, M.Y., K.T. and H.T.; formal analysis, M.K.; investigation, M.K.; resources, M.K.; data curation, T.T.; writing—original draft preparation, M.K.; writing—review and editing, A.M.; visualization, M.Y.; supervision, T.T.; project administration, M.K. All authors have read and agreed to the published version of the manuscript. The authors had signed the consent paper.
Funding
This research received no external funding.
Institutional Review Board Statement
The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of Aichi Prefectural University (protocol code: 1-43 and date of approval: 26 February 2021).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data presented in this study are available on request from the corresponding author.
Acknowledgments
We thank F. Nakajima (Japanese Red Cross Society, Tokyo, Japan) for granting us permission to reproduce the data on HLA alleles in Japanese individuals [9].
Conflicts of Interest
The authors declare no conflict of interest.
Abbreviations
| T1D | Type 1 diabetes |
| LADA | latent autoimmune diabetes in adults |
| HLA | human leukocyte antigen |
| GAD | glutamic acid decarboxylase |
| GAD-Ab | GAD antibody |
| IA-2Ab | insulinoma-associated antigen-2 antibody |
| SBT | sequence-based typing |
| BIGDAWG | Bridging ImmunoGenomic Data-Analysis Workflow Gaps |
| BMI | body mass index |
References
- Kawasaki, E.; Matsuura, N.; Eguchi, K. Type 1 diabetes in Japan. Diabetologia 2006, 49, 828–836. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Katahira, M.; Segawa, S.; Maeda, H.; Yasuda, Y. Effect of human leukocyte antigen class II genes on acute-onset and slow-onset type 1 diabetes in the Japanese population. Hum. Immunol. 2010, 71, 789–794. [Google Scholar] [CrossRef]
- Fourlanos, S.; Dotta, F.; Greenbaum, C.J.; Palmer, J.P.; Rolandsson, O.; Colman, P.G.; Harrison, L.C. Latent autoimmune dia-betes in adults (LADA) should be less latent. Diabetologia 2005, 48, 2206–2212. [Google Scholar] [CrossRef] [Green Version]
- Chen, W.; Chen, X.; Zhang, M.; Huang, Z. The association of human leukocyte antigen class II (HLA II) haplotypes with the risk of Latent autoimmune diabetes of adults (LADA): Evidence based on available data. Gene 2021, 767, 145177. [Google Scholar] [CrossRef]
- Kawabata, Y.; Ikegami, H. Genetics of fulminant type 1 diabetes. Diabetol. Int. 2020, 11, 315–322. [Google Scholar] [CrossRef] [PubMed]
- Thomson, G.; Valdes, A.M.; Noble, J.A.; Kockum, I.; Grote, M.N.; Najman, J.; Erlich, H.A.; Cucca, F.; Pugliese, A.; Steenkiste, A.; et al. Relative predispositional effects of HLA class II DRB1-DQB1 haplotypes and genotypes on type 1 diabetes: A meta-analysis. Tissue Antigens 2007, 70, 110–127. [Google Scholar] [CrossRef] [PubMed]
- Todd, J.A.; Bell, J.I.; McDevitt, H.O. HLA-DQ beta gene contributes to susceptibility and resistance to insulin-dependent dia-betes mellitus. Nature 1987, 329, 599–604. [Google Scholar] [CrossRef] [PubMed]
- Khalil, I.; D’Auriol, L.; Gobet, M.; Morin, L.; Lepage, V.; Deschamps, I.; Park, M.S.; Degos, L.; Galibert, F.; Hors, J. A combination of HLA-DQ beta Asp57-negative and HLA DQ alpha Arg52 confers susceptibility to insulin-dependent diabetes mellitus. J. Clin. Investig. 1990, 85, 1315–1319. [Google Scholar] [CrossRef] [PubMed]
- Nakajima, F.; Nakamura, J.; Yokota, T. Analysis of HLA haplotypes in Japanese, using high resolution allele typing. Major Histocompat. Complex 2001, 8, 1–32. [Google Scholar] [CrossRef] [Green Version]
- Alberti, K.G.; Zimmet, P.Z. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet. Med. 1998, 15, 539–553. [Google Scholar] [CrossRef]
- Katahira, M.; Hanakita, M.; Yasuda, Y.; Maeda, H.; Ito, T.; Segawa, S. Effect of human leukocyte antigen class II genes on insulin deficiency in slow-onset type 1 diabetes in the Japanese population. Diabetes Res. Clin. Pr. 2011, 93, e33–e36. [Google Scholar] [CrossRef]
- Katahira, M.; Ishiguro, T.; Segawa, S.; Kuzuya-Nagao, K.; Hara, I.; Nishisaki, T. Reevaluation of Human Leukocyte Antigen DR-DQ Haplotype and Genotype in Type 1 Diabetes in the Japanese Population. Horm. Res. 2008, 69, 284–289. [Google Scholar] [CrossRef] [PubMed]
- Pappas, D.J.; Marin, W.; Hollenbach, J.A.; Mack, S.J. Bridging ImmunoGenomic Data Analysis Workflow Gaps (BIGDAWG): An integrated case-control analysis pipeline. Hum. Immunol. 2016, 77, 283–287. [Google Scholar] [CrossRef] [Green Version]
- Benjamini, Y.; Hochberg, Y. Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. J. R. Stat. Soc. Ser. B Stat. Methodol. 1995, 57, 289–300. [Google Scholar] [CrossRef]
- Naito, T.; Suzuki, K.; Hirata, J.; Kamatani, Y.; Matsuda, K.; Toda, T.; Okada, Y. A deep learning method for HLA imputation and trans-ethnic MHC fine-mapping of type 1 diabetes. Nat. Commun. 2021, 12, 1639. [Google Scholar] [CrossRef] [PubMed]
- Hu, X.; Deutsch, A.J.; Lenz, T.L.; Onengut-Gumuscu, S.; Han, B.; Chen, W.-M.; Howson, J.M.M.; Todd, J.A.; Bakker, P.I.W.D.; Rich, S.S.; et al. Additive and interaction effects at three amino acid positions in HLA-DQ and HLA-DR molecules drive type 1 diabetes risk. Nat. Genet. 2015, 47, 898–905. [Google Scholar] [CrossRef] [Green Version]
- Gerasimou, P.; Nicolaidou, V.; Skordis, N.; Picolos, M.; Monos, D.; Costeas, P.A. Combined effect of glutamine at position 70 of HLA-DRB1 and alanine at position 57 of HLA-DQB1 in type 1 diabetes: An epitope analysis. PLoS ONE 2018, 13, e0193684. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Luo, S.; Lin, J.; Xie, Z.; Xiang, Y.; Zheng, P.; Huang, G.; Li, X.; Liao, Y.; Hagopian, W.A.; Wang, C.-Y.; et al. HLA Genetic Discrepancy Between Latent Autoimmune Diabetes in Adults and Type 1 Diabetes: LADA China Study No. 6. J. Clin. Endocrinol. Metab. 2016, 101, 1693–1700. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zhang, M.; Lin, S.; Yuan, X.; Lin, Z.; Huang, Z. HLA-DQB1 and HLA-DRB1 Variants Confer Susceptibility to Latent Auto-immune Diabetes in Adults: Relative Predispositional Effects among Allele Groups. Genes 2019, 10, 710. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Desai, M.; Zeggini, E.; Horton, V.A.; Owen, K.R.; Hattersley, A.T.; Levy, J.C.; Walker, M.; Gillespie, K.M.; Bingley, P.J.; Hitman, G.A.; et al. An association analysis of the HLA gene region in latent autoimmune diabetes in adults. Diabetologia 2006, 50, 68–73. [Google Scholar] [CrossRef] [Green Version]
- Tuomi, T.; Carlsson, A.; Li, H.; Isomaa, B.; Miettinen, A.; Nilsson, A.; Nissén, M.; Ehrnström, B.O.; Forsén, B.; Snickars, B.; et al. Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies. Diabetes 1999, 48, 150–157. [Google Scholar] [CrossRef]
- Sanjeevi, C.B.; Gambelunghe, G.; Falorni, A.; Kanungo, A.; Shtauvere-Brameus, A. Genetics of Latent Autoimmune Diabetes in Adults. Ann. N.Y. Acad. Sci. 2006, 958, 107–111. [Google Scholar] [CrossRef]
- Hosszúfalusi, N.; Vatay, A.; Rajczy, K.; Prohászka, Z.; Pozsonyi, E.; Horváth, L.; Grosz, A.; Gerõ, L.; Madácsy, L.; Romics, L.; et al. Similar genetic features and different islet cell autoantibody pattern of latent autoimmune di-abetes in adults (LADA) compared with adult-onset type 1 diabetes with rapid progression. Diabetes Care 2003, 26, 452–457. [Google Scholar] [CrossRef] [Green Version]
- Hirsch, D.; Narinski, R.; Klein, T.; Israel, S.; Singer, J. Immunogenetics of HLA class II in Israeli patients with adult-onset Type 1 diabetes mellitus. Hum. Immunol. 2007, 68, 616–622. [Google Scholar] [CrossRef] [PubMed]
- Zhou, Z.; Xiang, Y.; Ji, L.; Jia, W.; Ning, G.; Huang, G.; Yang, L.; Lin, J.; Liu, Z.; Hagopian, W.A.; et al. Frequency, Immunogenetics, and Clinical Characteristics of Latent Autoimmune Diabetes in China (LADA China Study): A Nationwide, Multicenter, Clinic-Based Cross-Sectional Study. Diabetes 2012, 62, 543–550. [Google Scholar] [CrossRef] [Green Version]
- Cervin, C.; Lyssenko, V.; Bakhtadze, E.; Lindholm, E.; Nilsson, P.; Tuomi, T.; Cilio, C.M.; Groop, L. Genetic Similarities Between Latent Autoimmune Diabetes in Adults, Type 1 Diabetes, and Type 2 Diabetes. Diabetes 2008, 57, 1433–1437. [Google Scholar] [CrossRef] [Green Version]
- Okruszko, A.; Szepietowska, B.; Wawrusiewicz-Kurylonek, N.; Gorska, M.; Kretowski, A.; Szelachowska, M. HLA-DR, HLA-DQB1 and PTPN22 gene polymorphism: Association with age at onset for autoimmune diabetes. Arch. Med. Sci. 2012, 5, 874–878. [Google Scholar] [CrossRef] [PubMed]
- Yamagata, K.; Nakajima, H.; Hanafusa, T.; Noguchi, T.; Miyazaki, A.; Miyagawa, J.; Sada, M.; Amemiya, H.; Tanaka, T.; Kono, N.; et al. Aspartic acid at position 57 of DQ beta chain does not protect against type 1 (insulin-dependent) diabetes mellitus in Japanese subjects. Diabetologia 1989, 32, 762–764. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Awata, T.; Kuzuya, T.; Matsuda, A.; Iwamoto, Y.; Kanazawa, Y.; Okuyama, M.; Juji, T. High frequency of aspartic acid at position 57 of HLA-DQ beta-chain in Japanese IDDM patients and nondiabetic subjects. Diabetes 1990, 39, 266–269. [Google Scholar] [CrossRef] [Green Version]
- Ikegami, H.; Tahara, Y.; Cha, T.; Yamato, E.; Ogihara, T.; Noma, Y.; Shima, K. Aspartic acid at position 57 of the HLA-DQ beta chain is not protective against insulin-dependent diabetes mellitus in Japanese people. J. Autoimmun. 1990, 3, 167–174. [Google Scholar] [CrossRef]
- Jacobs, K.; Jenkins, D.; Mijovic, C.; Penny, M.; Uchigata, Y.; Cavan, D.; Hirata, Y.; Otani, T.; Fletcher, J.; Barnett, A. An investigation of Japanese subjects maps susceptibility to type 1 (insulin-dependent) diabetes mellitus close to the DQA1 gene. Hum. Immunol. 1992, 33, 24–28. [Google Scholar] [CrossRef]
- Lee, H.; Ikegami, H.; Fugisana, T.; Ogihara, T.; Park, S.; Chung, Y.; Park, J.; Lee, E.; Lim, S.; Kim, K.; et al. Role of HLA class II alleles in Korean patients with IDDM. Diabetes Res. Clin. Pract. 1996, 31, 9–15. [Google Scholar] [CrossRef]
- Yu, J.; Shin, C.H.; Yang, S.W.; Park, M.H.; Eisenbarth, G.S. Analysis of children with type 1 diabetes in Korea: High prevalence of specific anti-islet autoantibodies, immunogenetic similarities to Western populations with “unique” haplotypes, and lack of discrimination by aspartic acid at position 57 of DQB. Clin. Immunol. 2004, 113, 318–325. [Google Scholar] [CrossRef] [PubMed]
- Rønningen, K.S.; Iwe, T.; Halstensen, T.S.; Spurkland, A.; Thorsby, E. The amino acid at position 57 of the HLA-DQ beta chain and susceptibility to develop insulin-dependent diabetes mellitus. Hum. Immunol. 1989, 26, 215–225. [Google Scholar] [CrossRef]
- Sanjeevi, C.B.; Lybrand, T.P.; DeWeese, C.; Landin-Olsson, M.; Kockum, I.; Dahlquist, G.; Sundkvist, G.; Stenger, D.; Lernmark, A. Polymorphic amino acid variations in HLA-DQ are associated with systematic physical property changes and occurrence of IDDM. Members of the Swedish Childhood Diabetes Study. Diabetes 1995, 44, 125–131. [Google Scholar] [CrossRef]
- Xia, Y.; Li, X.; Huang, G.; Lin, J.; Luo, S.; Xie, Z.; Zhou, Z. The association of HLA-DP loci with autoimmune diabetes in Chinese. Diabetes Res. Clin. Pr. 2021, 173, 108582. [Google Scholar] [CrossRef] [PubMed]
- Mishra, R.; Åkerlund, M.; Cousminer, D.L.; Ahlqvist, E.; Bradfield, J.P.; Chesi, A.; Hodge, K.M.; Guy, V.C.; Brillon, D.J.; Pratley, R.E.; et al. Genetic Discrimination Between LADA and Childhood-Onset Type 1 Diabetes Within the MHC. Diabetes Care 2019, 43, 418–425. [Google Scholar] [CrossRef] [PubMed]
Table 1.
HLA-DRB1 and -DRB1 allele frequencies in patients with classical T1D, patients with LADA, and in controls.
Table 1.
HLA-DRB1 and -DRB1 allele frequencies in patients with classical T1D, patients with LADA, and in controls.
| Allele | Allele Frequency (Number) | Classical T1D vs. Control | LADA vs. Control | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Classical T1D (n = 144) | LADA (n = 204) | Control (n = 516) | p | Pc | OR (95%CI) | p | Pc | OR (95%CI) | |
| DRB1*01:01 | 4.9 (7) | 4.9 (10) | 3.9 (20) | 0.37 | — | 1.27 (0.53–3.06) | 0.33 | — | 1.28 (0.59–2.78) |
| DRB1*04:01 | 0.7 (1) | 2.0 (4) | 1.4 (7) | 0.45 | — | 0.51 (0.06–4.17) | 0.38 | — | 1.45 (0.42–5.02) |
| DRB1*04:03 | 0.7 (1) | 3.4 (7) | 3.9 (20) | 0.037 | — | 0.17 (0.02–1.30) | 0.49 | — | 0.88 (0.37–2.12) |
| DRB1*04:05 | 29.2 (42) | 16.2 (33) | 13.2 (68) | 1.2 × 10−5 | 6.0 × 10−5 | 2.71 (1.75–4.22) | 0.18 | — | 1.27 (0.81–2.00) |
| DRB1*04:06 | 0.7 (1) | 4.4 (9) | 3.5 (18) | 0.056 | — | 0.19 (0.03–1.46) | 0.35 | — | 1.28 (0.56–2.89) |
| DRB1*04:07 | 0.7 (1) | 2.9 (6) | 0.4 (2) | 0.52 | — | 1.80 (0.16–20.0) | 0.0080 | 0.0400 | 7.79 (1.56–38.9) |
| DRB1*04:10 | 2.1 (3) | 3.0 (5) | 2.1 (11) | 0.64 | — | 0.98 (0.27–3.55) | 0.10 | — | 0.23 (0.03–1.76) |
| DRB1*08:02 | 9.0 (13) | 6.9 (14) | 3.5 (18) | 0.0080 | 0.0183 | 2.75 (1.31–5.75) | 0.041 | 0.15 | 2.04 (0.99–4.18) |
| DRB1*08:03 | 2.1 (3) | 4.4 (9) | 6.4 (33) | 0.027 | — | 0.31 (0.09–1.03) | 0.20 | — | 0.68 (0.32–1.44) |
| DRB1*09:01 | 27.1 (39) | 25.0 (51) | 13.8 (71) | 2.2 × 10−4 | 7.2 × 10−4 | 2.33 (1.49–3.63) | 3.1 × 10−4 | 0.0031 | 2.09 (1.40–3.13) |
| DRB1*11:01 | 0.0 (0) | 1.5 (3) | 3.7 (19) | 0.0086 | 0.0185 | 0 | 0.089 | — | 0.39 (0.11–1.33) |
| DRB1*12:01 | 0.7 (1) | 3.4 (7) | 2.5 (13) | 0.15 | — | 0.27 (0.04–2.09) | 0.33 | — | 1.38 (0.54–3.50) |
| DRB1*12:02 | 0.7 (1) | 0.5 (1) | 2.1 (11) | 0.22 | — | 0.32 (0.04–2.51) | 0.10 | — | 0.23 (0.03–1.76) |
| DRB1*13:02 | 18.1 (26) | 6.4 (13) | 5.6 (29) | 1.0 × 10−5 | 7.5 × 10−5 | 3.70 (2.10–6.52) | 0.41 | — | 1.14 (0.58–2.25) |
| DRB1*14:05 | 0.0 (0) | 1.0 (2) | 3.1 (16) | 0.0185 | 0.0370 | 0 | 0.077 | — | 0.31 (0.07–1.36) |
| DRB1*14:06 | 0.7 (1) | 0.5 (1) | 2.1 (11) | 0.22 | — | 0.32 (0.04–2.51) | 0.10 | — | 0.23 (0.03–1.76) |
| DRB1*14:54 | 0.7 (1) | 2.5 (5) | 4.3 (22) | 0.024 | — | 0.16 (0.02–1.18) | 0.18 | — | 0.56 (0.21–1.51) |
| DRB1*15:01 | 0.0 (0) | 3.9 (8) | 11.6 (60) | 1.7 × 10−7 | 5.2 × 10−6 | 0 | 5.8 × 10−4 | 0.0043 | 0.31 (0.15–0.66) |
| DRB1*15:02 | 0.7 (1) | 7.4 (15) | 8.9 (46) | 9.0 × 10−5 | 3.4 × 10−4 | 0.07 (0.01–0.52) | 0.30 | — | 0.81 (0.44–1.45) |
| DQB1*03:01 | 2.8 (4) | 6.4 (13) | 12.0 (62) | 2.9 × 10−4 | 8.7 × 10−4 | 0.21 (0.08–0.59) | 0.0152 | 0.06 | 0.50 (0.27–0.93) |
| DQB1*03:02 | 10.4 (15) | 17.6 (36) | 10.1 (52) | 0.51 | — | 1.04 (0.57–1.90) | 0.0046 | 0.0278 | 1.91 (1.21–3.03) |
| DQB1*03:03 | 26.4 (38) | 26.0 (53) | 14.5 (75) | 0.0010 | 0.0024 | 2.11 (1.35–3.29) | 3.1 × 10−4 | 0.0046 | 2.06 (1.39–3.07) |
| DQB1*04:01 | 29.2 (42) | 16.2 (33) | 13.0 (67) | 9.0 × 10−6 | 9.0 × 10−5 | 2.76 (1.77–4.29) | 0.16 | — | 1.29 (0.82–2.03) |
| DQB1*04:02 | 4.2 (6) | 2.5 (5) | 3.9 (20) | 0.52 | — | 1.08 (0.43–2.74) | 0.24 | — | 0.62 (0.23–1.68) |
| DQB1*05:01 | 4.9 (7) | 4.9 (10) | 4.5 (23) | 0.49 | — | 1.10 (0.46–2.61) | 0.47 | — | 1.11 (0.52–2.36) |
| DQB1*05:02 | 0.7 (1) | 1.5 (3) | 3.3 (17) | 0.069 | — | 0.21 (0.03–1.56) | 0.14 | — | 0.44 (0.13–1.51) |
| DQB1*05:03 | 0.0 (0) | 2.5 (5) | 5.4 (28) | 8.6 × 10−4 | 0.0024 | 0 | 0.06 | — | 0.44 (0.17–1.15) |
| DQB1*06:01 | 2.8 (4) | 11.8 (24) | 14.9 (77) | 1.1 × 10−5 | 6.6 × 10−5 | 0.16 (0.06–0.45) | 0.16 | — | 0.76 (0.47–1.24) |
| DQB1*06:02 | 0.0 (0) | 3.4 (7) | 11.6 (60) | 1.7 × 10−7 | 5.2 × 10−6 | 0 | 2.1 × 10−4 | 0.0064 | 0.27 (0.12–0.60) |
| DQB1*06:04 | 17.4 (25) | 6.4 (13) | 5.4 (28) | 1.6 × 10−5 | 6.9 × 10−5 | 3.66 (2.06–6.51) | 0.37 | — | 1.19 (0.60–2.34) |
T1D, type 1 diabetes; LADA, latent autoimmune diabetes in adults; OR, odds ratio. Significant ORs are expressed in bold.
Table 2.
HLA-DRB1 and -DQB1 amino acid frequencies at DR and DQ positions that showed an association with T1D and LADA in patients with classical T1D, those with LADA, and in controls.
Table 2.
HLA-DRB1 and -DQB1 amino acid frequencies at DR and DQ positions that showed an association with T1D and LADA in patients with classical T1D, those with LADA, and in controls.
| Amino Acid Position | Amino Acid Variants | Allele Frequency (Number) | Classical T1D vs. Control | LADA vs. Control | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Classical T1D (n = 144) | LADA (n = 204) | Control (n = 516) | p | Pc | OR (95%CI) | p | Pc | OR (95%CI) | ||
| DRß13 | Phe | 31.9 (46) | 29.9 (61) | 18.2 (94) | 4.2 × 10−4 | 0.0012 | 2.11 (1.39–3.19) | 5.4 × 10−4 | 0.0020 | 1.92 (1.32–2.78) |
| His | 34.7 (50) | 29.4 (60) | 24.4 (126) | 0.0099 | 0.0231 | 1.65 (1.11–2.45) | 0.10 | — | 1.29 (0.90–1.85) | |
| Tyr | 0.7 (1) | 0.0 (0) | 0.8 (4) | 0.70 | — | 0.90 (0.10–8.07) | 0.26 | — | 0 | |
| Gly | 12.5 (18) | 15.7 (32) | 14.5 (75) | 0.32 | — | 0.84 (0.48–1.46) | 0.39 | — | 1.09 (0.70–1.72) | |
| Ser | 19.4 (28) | 13.7 (28) | 20.7 (107) | 0.42 | — | 0.92 (0.58–1.47) | 0.0177 | 0.0374 | 0.61 (0.39–0.96) | |
| Arg | 0.7 (1) | 11.3 (23) | 21.3 (110) | 2.8 × 10−12 | 6.0 × 10−11 | 0.03 (0.004–0.19) | 8.9 × 10−4 | 0.0024 | 0.47 (0.29–0.76) | |
| DRß31 | Ile | 31.9 (46) | 29.9 (61) | 176 (91) | 2.3 × 10−4 | 7.9 × 10−4 | 2.19 (1.45–3.33) | 2.7 × 10−4 | 0.0013 | 1.99 (1.37–2.90) |
| Phe | 68.1 (98) | 70.1 (143) | 81.8 (422) | 4.2 × 10−4 | 0.0012 | 0.48 (0.31–0.72) | 5.4 × 10−4 | 0.0020 | 0.52 (0.36–0.76) | |
| Val | 0.0 (0) | 0.0 (0) | 0.6 (3) | 0.48 | — | 0 | 0.37 | — | 0 | |
| DRß33 | Asn | 65.3 (94) | 70.6 (144) | 75.6 (390) | 0.0099 | 0.0231 | 0.61 (0.41–0.90) | 0.10 | — | 0.78 (0.54–1.11) |
| His | 34.7 (50) | 29.4 (60) | 24.4 (126) | 0.0099 | 0.0231 | 1.65 (1.11–2.45) | 0.10 | — | 1.29 (0.90–1.85) | |
| DQß30 | Ser | 0.7 (1) | 0.0 (0) | 0.8 (4) | 0.70 | — | 0.90 (0.10–8.07) | 0.26 | — | 0 |
| Tyr | 76.4 (110) | 83.8 (171) | 80.2 (414) | 0.19 | — | 0.80 (0.51–1.24) | 0.16 | — | 1.28 (0.83–1.97) | |
| His | 22.9 (33) | 16.2 (33) | 19.0 (98) | 0.18 | — | 1.27 (0.81–1.98) | 0.22 | — | 0.82 (0.53–1.27) | |
| DQß70 | Arg | 61.1 (88) | 68.1 (139) | 58.0 (299) | 0.28 | — | 1.14 (0.78–1.66) | 0.0070 | 0.0167 | 1.55 (1.10–2.19) |
| Glu | 33.3 (48) | 18.6 (38) | 16.9 (87) | 2.5 × 10−5 | 1.1 × 10−4 | 2.47 (1.63–3.74) | 0.32 | — | 1.13 (0.74–1.72) | |
| Gly | 5.6 (8) | 13.2 (27) | 25.2 (130) | 1.6 × 10−8 | 1.7 × 10−7 | 0.18 (0.08–0.37) | 2.2 × 10−4 | 0.0042 | 0.45 (0.29–0.71) | |
| DQß75 | Val | 39.6 (57) | 27.5 (56) | 30.8 (159) | 0.0308 | 0.054 | 1.47 (1.00–2.16) | — | — | — |
| Leu | 60.4 (87) | 72.5 (148) | 69.2 (357) | 0.0308 | 0.054 | 0.68 (0.46–1.00) | — | — | — | |
| DQß85 | Leu | 73.6 (106) | 68.6 (140) | 54.3 (280) | 1.7 × 10−5 | 1.2 × 10−4 | 2.35 (1.56–3.54) | 2.6 × 10−4 | 0.0025 | 1.84 (1.31–2.60) |
| Val | 26.4 (38) | 31.4 (64) | 45.7 (236) | 1.7 × 10−5 | 1.2 × 10−4 | 0.43 (0.28–0.64) | 2.6 × 10−4 | 0.0025 | 0.54 (0.39–0.76) | |
T1D, type 1 diabetes; LADA, latent autoimmune diabetes in adults; OR, odds ratio. Significant ORs are expressed in bold.
Table 3.
HLA-DRB1 amino acid variants at positions 13, 31, and 33, and HLA-DQB1 amino acid variants at positions 70 and 85, which confer susceptibility to or protection against classical T1D or LADA.
Table 3.
HLA-DRB1 amino acid variants at positions 13, 31, and 33, and HLA-DQB1 amino acid variants at positions 70 and 85, which confer susceptibility to or protection against classical T1D or LADA.
| Amino Acid Position | Amino Acid Variants | Classical T1D | LADA | ||
|---|---|---|---|---|---|
| Allotypes | Allotypes | ||||
| DRß13 | Phe | S | (S) DRB1*09:01 | S | (S) DRB1*09:01 |
| His | S | (S) DRB1*04:05 | — | ||
| Ser | — | P | None | ||
| Arg | P | (P) DRB1*15:01, DRB1*15:02 | P | (P) DRB1*15:01 | |
| DRß31 | Ile | S | (S) DRB1*09:01 | S | (S) DRB1*09:01 |
| Phe | P | (S) DRB1*04:05, DRB1*08:02, DRB1*13:02 (P) DRB1*11:01, DRB1*14:05, DRB1*15:01, DRB1*15:02 | P | (S) DRB1*04:07 (P) DRB1*15:01 | |
| DRß33 | Asn | P | (S) DRB1*08:02, DRB1*09:01, DRB1*13:02 | — | |
| His | S | (P) DRB1*11:01, DRB1*14:05, DRB1*15:01, DRB1*15:02 | — | ||
| DQß70 | Arg | — | S | (S) DQB1*03:02, DQB1*03:03 | |
| Glu | S | (S) DQB1*04:01 | — | ||
| Gly | P | (P) DQB1*05:03, DQB1*06:02 | P | (P) DQB1*06:02 | |
| DQß85 | Leu | S | (S) DQB1*03:03, DQB1*04:01 | S | (S) DQB1*03:02, DQB1*03:03 |
| Val | P | (P) DQB1*03:01 | P | (P) DQB1*06:02 | |
S or P, respectively, indicates susceptibility to or protection against the diseases based on HLA-DRB1 and -DQB1 allotypes or amino acids. T1D, type 1 diabetes; LADA, latent autoimmune diabetes in adults. Allotypes which confer susceptibility to or protection against T1D or LADA in this study.
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Katahira, M.; Tsunekawa, T.; Mizoguchi, A.; Yamaguchi, M.; Tsuru, K.; Takashima, H.; Terada, R. Critical Amino Acid Variants in HLA-DRB1 and -DQB1 Allotypes in the Development of Classical Type 1 Diabetes and Latent Autoimmune Diabetes in Adults in the Japanese Population. Curr. Issues Mol. Biol. 2021, 43, 107-115. https://doi.org/10.3390/cimb43010009
AMA Style
Katahira M, Tsunekawa T, Mizoguchi A, Yamaguchi M, Tsuru K, Takashima H, Terada R. Critical Amino Acid Variants in HLA-DRB1 and -DQB1 Allotypes in the Development of Classical Type 1 Diabetes and Latent Autoimmune Diabetes in Adults in the Japanese Population. Current Issues in Molecular Biology. 2021; 43(1):107-115. https://doi.org/10.3390/cimb43010009
Chicago/Turabian StyleKatahira, Masahito, Taku Tsunekawa, Akira Mizoguchi, Mariko Yamaguchi, Kahori Tsuru, Hiromi Takashima, and Ryoma Terada. 2021. "Critical Amino Acid Variants in HLA-DRB1 and -DQB1 Allotypes in the Development of Classical Type 1 Diabetes and Latent Autoimmune Diabetes in Adults in the Japanese Population" Current Issues in Molecular Biology 43, no. 1: 107-115. https://doi.org/10.3390/cimb43010009
APA StyleKatahira, M., Tsunekawa, T., Mizoguchi, A., Yamaguchi, M., Tsuru, K., Takashima, H., & Terada, R. (2021). Critical Amino Acid Variants in HLA-DRB1 and -DQB1 Allotypes in the Development of Classical Type 1 Diabetes and Latent Autoimmune Diabetes in Adults in the Japanese Population. Current Issues in Molecular Biology, 43(1), 107-115. https://doi.org/10.3390/cimb43010009
