Auteur Topic: Twee auto-immuunziekten tegelijk: coeliakie en diabetes  (gelezen 528 keer)

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Twee auto-immuunziekten tegelijk: coeliakie en diabetes
« Gepost op: december 23, 2016, 16:29:11 »
Een paar procent van de coeliakiepatiŽnten krijgt na verloop van tijd ook diabetes type 1. De kans hierop is het grootst bij de gencombinatie HLA-DQ2.5/ HLA-DQ8.

Andersom ontwikkelen sommige diabetespatiŽnten coeliakie (6%). Bij hen is de kans hierop het grootst bij de gencombinatie HLA-DQ2.5/HLA-DQ2.5.

Dit blijkt uit een vergelijking van coeliakiepatiŽnten, diabetespatiŽnten en patiŽnten met beide aandoeningen.

Bron: proefschrift Sjoerd Bakker VUmc december 2016

Diabetes Care. 2015 Oct;38 Suppl 2:S37-44. doi: 10.2337/dcs15-2007.
Contrasting the Genetic Background of Type 1 Diabetes and Celiac Disease Autoimmunity.
Gutierrez-Achury J1, Romanos J1, Bakker SF2, Kumar V1, de Haas EC1, Trynka G1, RicaŮo-Ponce I1, Steck A3; Type 1 Diabetes Genetics Consortium, Chen WM4, Onengut-Gumuscu S4, Simsek S5; Diabeter, Rewers M3, Mulder CJ2, Liu E3, Rich SS4, Wijmenga C6.

Type 1 diabetes (T1D) and celiac disease (CeD) cluster in families and can occur in the same individual. Genetic loci have been associated with susceptibility to both diseases. Our aim was to explore the genetic differences between individuals developing both these diseases (double autoimmunity) versus those with only one. We hypothesized that double autoimmunity individuals carry more of the genetic risk markers that are shared between the two diseases independently. SNPs were genotyped in loci associated with T1D (n=42) and CeD (n=28) in 543 subjects who developed double autoimmunity, 2,472 subjects with T1D only, and 2,223 CeD-only subjects. For identification of loci that were specifically associated with individuals developing double autoimmunity, two association analyses were conducted: double autoimmunity versus T1D and double autoimmunity versus CeD. HLA risk haplotypes were compared between the two groups. The CTLA4 and IL2RA loci were more strongly associated with double autoimmunity than with either T1D or CeD alone. HLA analyses indicated that the T1D high-risk genotype, DQ2.5/DQ8, provided the highest risk for developing double autoimmunity (odds ratio 5.22, P=2.25◊10(-29)). We identified a strong HLA risk genotype (DQ2.5/DQ8) predisposing to double autoimmunity, suggesting a dominant role for HLA. Non-HLA loci, CTLA4 and IL2RA, may also confer risk to double autoimmunity. Thus, CeD patients who carry the DQ2.5/DQ8 genotype may benefit from periodic screening of autoantibodies related to T1D.

PMID: 26405070 PMCID: PMC4582914 DOI: 10.2337/dcs15-2007

http://dare.ubvu.vu.nl/handle/1871/54824
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