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Heneberg P. Diabetes in stiff-person syndrome. Trends Endocrinol Metab 2023; 34:640-651. [PMID: 37586963 DOI: 10.1016/j.tem.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/08/2023] [Accepted: 07/24/2023] [Indexed: 08/18/2023]
Abstract
Anti-glutamic acid decarboxylase (GAD) autoantibodies are a hallmark of stiff-person syndrome (SPS) and insulin-dependent diabetes mellitus (IDDM). However, patients with concurrent IDDM and SPS often manifest insulin resistance, and SPS-associated IDDM probably has heterogeneous causes. Some patients manifest IDDM associated only with high titers of anti-GAD65 caused by SPS. By contrast, other patients develop IDDM only after being treated with high-dose corticosteroids or they progress to insulin dependency following their treatment with high-dose corticosteroids. The profile of autoantibodies differs markedly between type 1 diabetes mellitus (T1DM), late-onset diabetes mellitus, and SPS-associated IDDM. Therefore, as with new-onset diabetes after transplantation (NODAT), SPS-associated IDDM should be classified as a specific diabetes entity, the pathophysiology of which requires increased attention.
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Affiliation(s)
- Petr Heneberg
- Charles University, Third Faculty of Medicine, Prague, Czech Republic.
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Trier NH, Valdarnini N, Fanelli I, Rovero P, Hansen PR, Schafer-Nielsen C, Ciplys E, Slibinskas R, Pociot F, Friis T, Houen G. Peptide Antibody Reactivity to Homologous Regions in Glutamate Decarboxylase Isoforms and Coxsackievirus B4 P2C. Int J Mol Sci 2022; 23:ijms23084424. [PMID: 35457242 PMCID: PMC9028130 DOI: 10.3390/ijms23084424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 12/04/2022] Open
Abstract
Two isoforms of the glutamate decarboxylase (GAD) enzyme exist, GAD65 and GAD67, which are associated with type 1 diabetes (T1D) and stiff-person syndrome (SPS), respectively. Interestingly, it has been reported that T1D patients seldom develop SPS, whereas patients with SPS occasionally develop T1D. In addition, coxsackievirus B4 (CVB4) has previously been proposed to be involved in the onset of T1D through molecular mimicry. On this basis, we aimed to examine antibody cross-reactivity between a specific region of GAD65 and GAD67, which has high sequence homology to the nonstructural P2C protein of CVB4 to determine potential correlations at antibody level. Monoclonal peptide antibodies generated in mice specific for a region with high similarity in all three proteins were screened for reactivity along with human sera in immunoassays. In total, six antibodies were generated. Two of the antibodies reacted to both GAD isoforms. However, none of the antibodies were cross-reactive to CVB, suggesting that antibody cross-reactivity between GAD65 and CVB, and GAD67 and CVB may not contribute to the onset of T1D and SPS, respectively.
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Affiliation(s)
- Nicole Hartwig Trier
- Department of Neurology, Rigshospitalet Glostrup, Valdemar Hansens vej 13, 2600 Glostrup, Denmark
- Correspondence: (N.H.T.); (G.H.)
| | - Niccolo Valdarnini
- Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, Department of NeuroFarBa, University of Florence, Via Ugo Schiff 6, I-50019 Sesto Fiorentino, Italy; (N.V.); (I.F.); (P.R.)
| | - Ilaria Fanelli
- Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, Department of NeuroFarBa, University of Florence, Via Ugo Schiff 6, I-50019 Sesto Fiorentino, Italy; (N.V.); (I.F.); (P.R.)
| | - Paolo Rovero
- Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, Department of NeuroFarBa, University of Florence, Via Ugo Schiff 6, I-50019 Sesto Fiorentino, Italy; (N.V.); (I.F.); (P.R.)
| | - Paul Robert Hansen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark;
| | | | - Evaldas Ciplys
- Life Sciences Center, Institute of Biotechnology, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania; (E.C.); (R.S.)
| | - Rimantas Slibinskas
- Life Sciences Center, Institute of Biotechnology, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania; (E.C.); (R.S.)
| | - Flemming Pociot
- Steno Diabetes Center, Borgmester Ib Juuls Vej 83, 2730 Hellerup, Denmark;
| | - Tina Friis
- Department of Autoimmunity and Biomarkers, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark;
| | - Gunnar Houen
- Department of Neurology, Rigshospitalet Glostrup, Valdemar Hansens vej 13, 2600 Glostrup, Denmark
- Department Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Correspondence: (N.H.T.); (G.H.)
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Valdarnini N, Holm B, Hansen P, Rovero P, Houen G, Trier N. Fine Mapping of Glutamate Decarboxylase 65 Epitopes Reveals Dependency on Hydrophobic Amino Acids for Specific Interactions. Int J Mol Sci 2019; 20:ijms20122909. [PMID: 31207885 PMCID: PMC6627456 DOI: 10.3390/ijms20122909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 01/10/2023] Open
Abstract
Characterization of multiple antibody epitopes has revealed the necessity of specific groups of amino acid residues for reactivity. This applies to the majority of antibody-antigen interactions, where especially charged and hydrophilic amino acids have been reported to be essential for antibody reactivity. This study describes thorough characterization of glutamic acid decarboxylase (GAD) 65 antigenic epitopes, an immunodominant autoantigen in type 1 diabetes (T1D). As linear epitopes are sparsely described for GAD65 in T1D, we aimed to identify and thoroughly characterize two GAD65 antibodies using immunoassays. A monoclonal antibody recognized an epitope in the N-terminal domain of GAD65, 8FWSFGSE14, whereas a polyclonal antibody recognized two continuous epitopes in the C-terminal domain, corresponding to amino acids 514RTLED518 and 549PLGDKVNF556. Hydrophobic amino acids were essential for antibody reactivity, which was verified by competitive inhibition assays. Moreover, the epitopes were located in flexible linker regions and turn structures. These findings confirm the versatile nature of antibody-antigen interactions and describe potential continuous epitopes related to T1D, which predominantly have been proposed to be of discontinuous nature.
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Affiliation(s)
- Niccolò Valdarnini
- Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, Department of NeuroFarBa, University of Florence, Via Ugo Schiff, 6, 50019 Sesto Fiorentino, Italy.
| | - Bettina Holm
- Department of Clinical Immunology, Rigshospitalet, Ole Maaløes vej 26, 2200 Copenhagen N, Denmark.
| | - Paul Hansen
- Department of Drug Design and Pharmacology, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Paolo Rovero
- Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, Department of NeuroFarBa, University of Florence, Via Ugo Schiff, 6, 50019 Sesto Fiorentino, Italy.
| | - Gunnar Houen
- Department of Neurology, Rigshospitalet Glostrup, Nordre Ringvej 57, 2600 Glostrup, Denmark.
| | - Nicole Trier
- Department of Neurology, Rigshospitalet Glostrup, Nordre Ringvej 57, 2600 Glostrup, Denmark.
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Agca S, Houen G, Trier NH. Characterization of continuous B-cell epitopes in the N-terminus of glutamate decarboxylase67 using monoclonal antibodies. J Pept Sci 2014; 20:928-34. [DOI: 10.1002/psc.2703] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Selin Agca
- Department of Clinical Biochemistry, Immunology and Genetics; Statens Serum Institut; Artillerivej 5 2300 Copenhagen S Denmark
- Department of Molecular Biology and Genetics; Aarhus University; Forskerparken - Gustav Wieds Vej 10 8000 Aarhus C Denmark
| | - Gunnar Houen
- Department of Clinical Biochemistry, Immunology and Genetics; Statens Serum Institut; Artillerivej 5 2300 Copenhagen S Denmark
| | - Nicole Hartwig Trier
- Department of Clinical Biochemistry, Immunology and Genetics; Statens Serum Institut; Artillerivej 5 2300 Copenhagen S Denmark
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Analysis of the GAD65-GAD65 autoantibody interaction. Clin Chim Acta 2008; 391:51-9. [PMID: 18328264 DOI: 10.1016/j.cca.2008.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Revised: 01/31/2008] [Accepted: 02/04/2008] [Indexed: 11/23/2022]
Abstract
BACKGROUND GAD(65)Ab are important markers of risk of development of type 1 DM. METHODS With the need to improve the disease specificity of GAD(65)Ab measurement in mind, we have analysed the interaction between recombinant human GAD(65) and GAD(65)Ab from different groups of subjects in terms of association and dissociation rate constants and equilibrium constants. In addition, binding of GAD(65)Ab from various groups of subjects to wild-type GAD(65) versus GAD(65) containing a mutation E517P was studied. RESULTS Affinity constants for serum GAD(65)Ab in 12 type 1 DM patients ranged from 0.9 x 10(10) L/mol to 11.2 x 10(10) L/mol and from 0.8 x 10(10) L/mol to 14.0 x 10(10) L/mol in sera from 11 individuals without type 1 DM. Serum GAD(65)Ab concentrations assessed by Scatchard analysis ranged from 0.04 to 24.8 microg/mL in type 1 DM patients (n=12) and from 0.04 to 141.8 microg/mL in individuals without type 1 DM (n=11). CONCLUSIONS Overall, our study indicated that GAD(65)Ab in different patients studied showed similar association and dissociation rate constants and similar affinity constants. However, GAD(65)Ab concentrations vary widely between different sera. There was a modest reduction of the median binding of GAD(65)Ab to GAD(65) E517P in the group of patients with type 1 DM compared to patients without type 1 DM.
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Quinn A, McInerney M, Huffman D, McInerney B, Mayo S, Haskins K, Sercarz E. T cells to a dominant epitope of GAD65 express a public CDR3 motif. Int Immunol 2006; 18:967-79. [PMID: 16641112 DOI: 10.1093/intimm/dxl033] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Non-obese diabetic (NOD) mice spontaneously develop autoimmune diabetes, and serve as a model for type 1 diabetes (T1D) and natural autoimmunity. T cell responses to the pancreatic islet antigen glutamic acid decarboxylase 65 (GAD65) can be detected in the spleens of young prediabetic NOD mice, which display a unique MHC class II molecule. Here, we report that a distinct TcR beta chain and CDR3 motif are utilized by all NOD mice in response to a dominant determinant on GAD65, establishing a public repertoire in the spontaneous autoimmunity to an important islet cell antigen. GAD65 530-543 (p530)-reactive T cells preferentially utilize the Vbeta4, Dbeta2.1 and Jbeta2.7 gene segments, with a CDR3 that is characterized by a triad of amino acids, DWG, preceded by a polar residue. In addition, we used CDR3 length spectratyping, CDR3-specific reverse transcriptase-PCR and direct TcR sequencing to show that the TcR beta chain structural patterns associated with p530-specific T cells consistently appeared in the islets of young NOD mice with insulitis, but not in the inflamed islets of streptozotocin-treated C57BL/6 mice, or in inflamed NOD salivary glands. To our knowledge, this is the first report to demonstrate that a public T cell repertoire is used in spontaneous autoimmunity to a dominant self-determinant. These findings suggest that defined clonotypes and repertoires may be preferentially selected in haplotypes predisposed to spontaneous autoimmunity.
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MESH Headings
- Amino Acid Motifs/genetics
- Amino Acid Motifs/immunology
- Animals
- Autoimmunity/genetics
- Autoimmunity/immunology
- Complementarity Determining Regions/genetics
- Complementarity Determining Regions/immunology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/immunology
- Epitopes, T-Lymphocyte/genetics
- Epitopes, T-Lymphocyte/immunology
- Female
- Gene Rearrangement, beta-Chain T-Cell Antigen Receptor/genetics
- Gene Rearrangement, beta-Chain T-Cell Antigen Receptor/immunology
- Glutamate Decarboxylase/immunology
- Inflammation/genetics
- Inflammation/immunology
- Inflammation/pathology
- Isoenzymes/immunology
- Mice
- Mice, Inbred NOD
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Salivary Glands/immunology
- Salivary Glands/pathology
- T-Lymphocytes/immunology
- T-Lymphocytes/pathology
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Affiliation(s)
- Anthony Quinn
- Department of Biological Sciences, University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606-3390, USA.
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