Abstract
Type 1 diabetes (T1D) and autoimmune thyroid disease (AITD) are the most frequent chronic autoimmune diseases worldwide. Several autoimmune endocrine and non-endocrine disorders tend to occur together. T1D and AITD often cluster in individuals and families, seen in the formation of autoimmune polyendocrinopathy (AP). The close relationship between these two diseases is largely explained by sharing a common genetic background. The HLA antigens DQ2 (DQA1*0501-DQB1*0201) and DQ8 (DQA1*0301-DQB1*0302), tightly linked with DR3 and DR4, are the major common genetic predisposition. Moreover, functional single nucleotide polymorphisms (or rare variants) of various genes, such as the cytotoxic T-lymphocyte- associated antigen (CTLA4), the protein tyrosine phosphatase non-receptor type 22 (PTPN22), the interleukin-2 Receptor (IL2Ra), the Vitamin D receptor (VDR), and the tumor-necrosis-factor-α (TNF) that are involved in immune regulation have been identified to confer susceptibility to both T1D and AITD. Other genes including cluster of differentiation 40 (CD40), the forkhead box P3 (FOXP3), the MHC Class I Polypeptide-Related Sequence A (MICA), insulin variable number of tandem repeats (INS-VNTR), the C-Type Lectin Domain Containing 16A (CLEC16A), the Erb-B2 Receptor Tyrosine Kinase 3 (ERBB3) gene, the interferon-induced helicase C domain-containing protein 1 (IFIH1), and various cytokine genes are also under suspicion to increase susceptibility to T1D and AITD. Further, BTB domain and CNC homolog 2 (BACH2), C-C motif chemokine receptor 5 (CCR5), SH2B adaptor protein 3 (SH2B3), and Rac family small GTPase 2 (RAC2) are found to be associated with T1D and AITD by various independent genome wide association studies and overlap in our list, indicating a strong common genetic link for T1D and AITD. As several susceptibility genes and environmental factors contribute to the disease aetiology of both T1D and AITD and/or AP subtype III variant (T1D+AITD) simultaneously, all patients with T1D should be screened for AITD, and vice versa.
Highlights
Molecular Thyroid Research Laboratory, Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
Functional single nucleotide polymorphisms of various genes, such as the cytotoxic T-lymphocyte- associated antigen (CTLA4), the protein tyrosine phosphatase non-receptor type 22 (PTPN22), the interleukin-2 Receptor (IL2Ra), the Vitamin D receptor (VDR), and the tumor-necrosisfactor-a (TNF) that are involved in immune regulation have been identified to confer susceptibility to both Type 1 diabetes (T1D) and autoimmune thyroid disease (AITD)
As several susceptibility genes and environmental factors contribute to the disease aetiology of both T1D and AITD and/or autoimmune polyendocrinopathy (AP) subtype III variant (T1D+AITD) simultaneously, all patients with T1D should be screened for AITD, and vice versa
Summary
Type 1 diabetes (T1D) and autoimmune thyroid disease (AITD) are two frequent autoimmune endocrine disorders. AITD is frequently combined with T1D in populations of various ancestries, occurring together more often than expected by the population prevalence of each disease GD is less prevalent than HT, only affecting approximately 1–1.5% of the general population, but is the underlying cause of 50–80% of cases of autoimmune hyperthyroidism. The most prevalent AP type is the disease association of T1D and AITD in the same individual defined as subtype III variant. Further possible mechanisms of autoimmunity include the hygiene hypotheses, which could play an important role in the worldwide increase of autoimmune diseases. It states that pathogens, parasites and commensal microorganisms protect against a variety of autoimmune conditions. Even in countries with low disease incidence familial clustering has been observed [1]
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