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当 1 型糖尿病遇见乳糜泻。

When type 1 diabetes meets celiac disease.

机构信息

Blood Transfusion Centre of Slovenia, Tissue Typing Center, Ljubljana, Slovenia.

出版信息

HLA. 2018 Dec;92 Suppl 2:64-66. doi: 10.1111/tan.13441.

Abstract

Type1 diabetes (T1D) and celiac disease (CD) may occur together. HLA-DQ8 and DQ2 are key genetic risk factors in both. Overall, the patients with co-existing T1D and CD (T1D+CD) were shown to have HLA profile more similar to patients with T1D than those with CD. Slovenian patients with both diseases had the frequency of DQB102:01 (86.5%) very similar to patients with CD (83.8%) in contrast to the significantly different frequency of the same allele in patients with T1D (52.24%). The DQ2 conveyed higher risk for developing both T1D and CD in the same individual than DQ8. Additionally, the A1-B8-DR3-DQ2-MICA008 ancestral haplotype (8.1AH) was over-represented in Slovenian (T1D+CD) patients, where B08 was the most significant independent risk factor. Moreover, C07, that is also present in the 8.1AH, could have an impact on the innate immunity rout of this susceptibility through interaction with KIRs. In the genotype context, the CD risk in T1D patients was associated with DR3-DQ2/DR3-DQ2, whereas the risk for T1D in CD patients was associated with DR3-DQ2/DR4-DQ8. Less frequent screening for the second disease related antibodies could be considered in patients with the first disease and low risk genotype for obtaining the second-one. Individuals carrying high risk DR3-DQ2/DR3-DQ2 or DR3-DQ2/DR4DQ8 are more likely to develop both autoimmune diseases together than individuals carrying any other HLA genotypes.

摘要

1 型糖尿病(T1D)和乳糜泻(CD)可能同时发生。HLA-DQ8 和 DQ2 是这两种疾病的关键遗传风险因素。总体而言,同时患有 T1D 和 CD 的患者(T1D+CD)的 HLA 谱与 T1D 患者更为相似,而与 CD 患者不同。与 T1D 患者(52.24%)相比,患有这两种疾病的斯洛文尼亚患者 DQB102:01(86.5%)的频率非常相似,而 CD 患者的同一等位基因频率则非常相似(83.8%)。与 DQ8 相比,DQ2 传递了个体同时患 T1D 和 CD 的更高风险。此外,在斯洛文尼亚(T1D+CD)患者中,A1-B8-DR3-DQ2-MICA008 祖先单倍型(8.1AH)过度表达,其中 B08 是最显著的独立风险因素。此外,存在于 8.1AH 中的 C07 也可以通过与 KIRs 的相互作用影响这种易感性的固有免疫途径。在基因型背景下,T1D 患者的 CD 风险与 DR3-DQ2/DR3-DQ2 相关,而 CD 患者的 T1D 风险与 DR3-DQ2/DR4-DQ8 相关。对于具有低获得第二种疾病风险基因型的第一种疾病患者,可以考虑减少第二种疾病相关抗体的筛查。携带高风险 DR3-DQ2/DR3-DQ2 或 DR3-DQ2/DR4-DQ8 的个体比携带任何其他 HLA 基因型的个体更有可能同时患上这两种自身免疫性疾病。

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