The glutamic acid decarboxylase 65 immunoglobulin G subclass profile differs between adult-onset type 1 diabetes and latent autoimmune diabetes in adults (LADA) up to 3 years after clinical onset

Clin Exp Immunol. 2009 Aug;157(2):255-60. doi: 10.1111/j.1365-2249.2009.03939.x.

Abstract

Autoantibodies against glutamic acid decarboxylase 65 (GADA) are found frequently in patients with autoimmune diabetes. Immunoglobulin (Ig)G(1) is the most frequent subclass among the GADA IgG subclasses. IgG(4) is a more common subclass in latent autoimmune diabetes in adults (LADA) at clinical onset compared to type 1 diabetes. The aim of this work was to study the different GADA-IgG subclass profiles during a 3-year follow-up in these groups of autoimmune diabetes. Adult-onset subjects, classified as either type 1 (n = 40) or LADA (n = 43), were included in the study. New samples were collected every year from these patients. In addition to conventional GADA analyses, GADA-IgG subclasses were also analysed with a radioimmunoprecipitation assay using biotin-conjugated antibodies (directed against human IgG subclasses and IgM) and streptavidin Sepharose. During 3 years' follow-up, all the IgG subclass levels decreased in type 1 diabetes - IgG(1): P < 0.001; IgG(2): P < 0.001; IgG(3): P < 0.001; IgG(4): P < 0.05 (Friedman's' test) - while levels remained stable for all four subclasses in LADA. GADA IgM, however, decreased in both groups (P < 0.001). Patients with LADA have higher GADA IgG(3) and IgG(4) at clinical onset and seem to maintain the levels and profile of their IgG subclasses up to 3 years after clinical onset, while all the GADA IgG subclass levels decrease in type 1 diabetic patients. This indicates a persistent different immune response in LADA compared to type 1 diabetes and further indicates the difference in pathogenesis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Autoantibodies / classification*
  • Autoantibodies / immunology
  • C-Peptide / analysis
  • Diabetes Mellitus, Type 1 / immunology*
  • Female
  • Follow-Up Studies
  • Glutamate Decarboxylase / immunology*
  • Humans
  • Immunoglobulin G / analysis
  • Immunoglobulin G / classification*
  • Immunoglobulin M / analysis
  • Male
  • Middle Aged
  • Radioimmunoprecipitation Assay
  • Statistics, Nonparametric
  • Young Adult

Substances

  • Autoantibodies
  • C-Peptide
  • Immunoglobulin G
  • Immunoglobulin M
  • Glutamate Decarboxylase