Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine
Abstract
:1. Introduction
2. Materials and Methods
3. T1DMand Autoimmune Endocrine Pathology
3.1. Hashimoto’s Thyroiditis and Graves’ Disease
3.2. Addison’s Disease
3.3. Autoimmune Hypoparathyroidism
3.4. T1DM and Celiac Disease
3.5. Autoimmune Gastritis
3.6. T1DMand Autoimmune Skin Pathology
3.6.1. Hives
3.6.2. Alopecia
3.6.3. Psoriasis
3.7. T1DM and Rheumatological Autoimmune Pathology
3.7.1. Rheumatoid Arthritis
3.7.2. Sjogren’s Syndrome
3.7.3. Systemic Lupus Erythematosus
4. Moving towards Personalized Patient-Centered Management
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Autoimmune Pathology | Antibodies | Reference |
---|---|---|
Hashimoto’s thyroiditis | Antithyroid peroxidase antibodies Antithyroglobulin antibodies | [4,8] |
Basedow-Graves-disease | Antithyrotropin receptor antibodies (TRAb) | [11,12] |
Addison’s disease | Antibodies against 21-hydroxylase | [27,32] |
Hypoparathyroidism | Antibodies against CaSR(Calcium-Sensing Receptor) Anti NALP5-antibodies | [49] |
Celiac disease | Antibodies tissue transglutaminase Anti-endomysium antibodies Antigliadin antibodies | [50] |
Autoimmune gastritis | Antibodies against parietal cells Antibodies against intrinsec factor | [52] |
Rheumatoid arthritis | Rheumatoid factor FR AAN antinuclear antibodies | [56,76,82] |
Sjogrens disease | Antinuclear antibodies AAN Anti SS-A/anti-Ro antibodies Anti SS-B/anti-La-antibodies | [92,99] |
Antinuclear-AAN-antiboies Anti SS-A/anti-Ro antibodies- Anti SS-B/anti-La antibodies Anti-Sm (Smith)-antibodies Antibodies against double-stranded DNA (anti-dc-DNAantibody) | [102] |
Personalized Medicine | Application in T1DM | References |
---|---|---|
Personalized Diagnosis | ||
1. HbA1c in Diagnosis and Monitoring | HbA1c is affected by glucose levels, hemoglobin, and red cell stability. Unexpected HbA1c variations can be discovered by blood investigations and genetic testing, hence allowing an individualized approach. | [105] |
2. Subcategories in T1DM | Etiological types of T1DM can be established on basis of age of onset of diabetes and type of islet cell antibody present (GAD, ICA512/IA-2, insulin, zinc transporter 8 [ZnT8]) | [106] |
3. Early diagnosis of diabetic neuropathy—tight control of DM | Insulin and C-peptide deficiencies cause acute metabolic irregularities, persistent gene regulatory perturbations, poor neurotrophism, protein–protein interactions, and particular degenerative diseases in type 1 DPN (Diabetic Peripheral neuropathy). Hence, complications can be prevented by an individualized approach. | [107] |
Personalized Therapy | ||
1. Intensive insulin therapy | Individually tailored insulin therapy based on HbA1c has proven to be more beneficial. | [108] |
2. Immune therapy | Auto-aggressive T cell repertoire varies between patients and the number of residual beta-cells will directly affect insulin production post-treatment. Thus, a combination therapy can be more useful. | [109] |
3. Gene therapy | Restoration of insulin responsiveness, suppression of autoimmunity, functional replacement of pancreatic islets, and correction of vascular and nerve damage associated with prolonged hyperglycemia can all be done with gene therapy, and the future holds great promise for the same. | [110] |
Personalized Prevention and Risk Stratification | ||
1. Primary prevention of T1DM in pre-stage 1 | Individual genotyping of the genes on which more than 30% of the T1DM genetic risk is attributed to human leukocyte antigen (HLA) complex genes and more than 50 non-HLA loci. | [111] |
2. T1D genetic risk scores (T1D-GRS) | High T1D-GRS has low PPV in populations with low prevalence. | [111,112] |
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Popoviciu, M.S.; Kaka, N.; Sethi, Y.; Patel, N.; Chopra, H.; Cavalu, S. Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine. J. Pers. Med. 2023, 13, 422. https://doi.org/10.3390/jpm13030422
Popoviciu MS, Kaka N, Sethi Y, Patel N, Chopra H, Cavalu S. Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine. Journal of Personalized Medicine. 2023; 13(3):422. https://doi.org/10.3390/jpm13030422
Chicago/Turabian StylePopoviciu, Mihaela Simona, Nirja Kaka, Yashendra Sethi, Neil Patel, Hitesh Chopra, and Simona Cavalu. 2023. "Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine" Journal of Personalized Medicine 13, no. 3: 422. https://doi.org/10.3390/jpm13030422