Partial remission in Brazilian children and adolescents with type 1 diabetes. Association with a haplotype of class II human leukocyte antigen and synthesis of autoantibodies

Pediatr Diabetes. 2020 Jun;21(4):606-614. doi: 10.1111/pedi.12999. Epub 2020 Mar 6.

Abstract

Objective: Characterization of partial remission using the insulin dose-adjusted HbA1c (IDAA1c) ≤ 9 definition in a multiethnic Brazilian population of children and adolescents with type 1 diabetes (T1D), in addition with the determination of both Class II HLA genotype and autoantibodies.

Methods: We analyzed the prevalence of partial remission in 51 new-onset T1D patients with a median time follow-up of 13 months from diagnosis. For this study, anti-GAD65, anti-IA2 and HLA class II genotyping were considered.

Results: Partial remission occurred in 41.2% of T1D patients until 3 months after diagnosis, mainly in those aged 5-15 years. We have demonstrated a significant increase in the haplotypes of class II HLA DRB1*0301-DQB1*0201 in children and adolescents with a partial remission phase of the disease (42.9% vs 21.7% in non-remitters, P = .0291). This haplotype was also associated with the reduction of anti-IA2 antibodies production. Homozygote DRB1*03-DQB1*0201/DRB1*03-DQB1*0201 children had the lowest prevalence of IA-2A antibodies (P = .0402). However, this association does not correlate with the time of the remission phase.

Conclusion: Although the number of patients studied was reduced, our data suggested that the association between genetics and decrease in antibody production to certain islet auto-antigen may contribute, at least in part, to the remission phase of T1D.

Keywords: HLA class II; autoantibodies; diabetes mellitus type 1; partial remission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / biosynthesis*
  • Autoantibodies / genetics
  • Brazil / epidemiology
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetes Mellitus, Type 1* / genetics
  • Diabetes Mellitus, Type 1* / immunology
  • Diabetes Mellitus, Type 1* / pathology
  • Female
  • Gene Frequency
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • HLA-DQ Antigens / genetics
  • HLA-DRB1 Chains / genetics
  • Haplotypes
  • Histocompatibility Antigens Class II / genetics*
  • Humans
  • Infant
  • Male
  • Remission, Spontaneous
  • Young Adult

Substances

  • Autoantibodies
  • HLA-DQ Antigens
  • HLA-DRB1 Chains
  • Histocompatibility Antigens Class II