Gliadin, endomysial and thyroid antibodies in patients with latent autoimmune diabetes of adults (LADA)

Abstract

SUMMARYLatent autoimmune diabetes of adults (LADA) manifested after the age of 35 is characterized by the presence of disease-specific autoantibodies (anti-glutamate decarboxylase GADAb, anti-IA2Ab). However, autoimmunity in Type 1 diabetes mellitus is not targeted only to pancreatic beta-cells. No data have so far been published concerning the antibodies associated with other autoimmune disease in LADA patients. The presence of anti-thyroglobulin (TGAb), anti-thyroid peroxidase (TPOAb), antigliadin IgA (AGAAb) and IgG (AGGAb) and endomysial antibodies (EMAb) in sera of 68 diabetics typed as LADA was compared with the antibody presence in sera of 85 patients with Type 2 diabetes. We found a significantly higher occurrence of gliadin antibodies in LADA patients: the rate of AGGAb was 19·1% in comparison with 3·5% in the T2DM group ( P = 0·0026), the rate of AGAAb was 13·2% in comparison with 3·5% ( P = 0·035). The prevalence of EMAb was very low in both groups (1·5% and 0). The two groups differed significantly in the TPOAb rate: 22·1% in LADA compared to 9·4% in T2DM ( P = 0·04), whereas no significant difference was found in the presence of TGAb (8·8% and 3·5%, P = 0·187). In comparison with T2DM patients, LADA patients were found to express higher antibody activity against gluten-related antigens and against TPO.

The role of gut microbiota (commensal bacteria) and the mucosal barrier in the pathogenesis of inflammatory and autoimmune diseases and cancer: contribution of germ-free and gnotobiotic animal models of human diseases

“…The frequent association between celiac disease and other autoimmune diseases, particularly type 1 diabetes (T1D) and thyroiditis, suggests that celiac enteropathy shares certain pathogenic mechanisms with other autoimmune diseases. 80 Indeed, gut mucosal barrier dysfunction was repeatedly demonstrated and confirmed by genetic studies in patients with celiac disease and T1D. [81][82][83] Several intestinal viral triggers including adenovirus, hepatitis C virus, and rotavirus and bacterial infections capable of initiating or augmenting gut mucosal responses to gluten were suggested to play a role in the pathogenic mechanism of this disease.…”

Latent autoimmune diabetes in adults (LADA) should be less latent

“…A high frequency (19%) of antibodies to gliadin was reported in LADA [44], but the prevalence of coeliac disease confirmed by biopsy is unknown. An increased frequency of antibodies to 21-hydroxylase and 17-hydroxylase, markers of autoimmune hypoadrenalism (Addison's disease), has also been reported in LADA [43].…”

Latent autoimmune diabetes in the young

“…The phenomenon of recruitment of additional T cell epitopes has been reported. 12 The presence of obesity is not incompatible with diagnosis of immune mediated diabetes. Studies report a mean BMI in the overweight category (BMI >25.0 kg/m 2 ) in a LADA population of European extraction.…”

“…12 The prevalence of thyroid antibodies in adult patients with type 1 diabetes has been reported to be between 20-30%. A recent study showed the presence of thyroid peroxidase antibodies in LADA (22.1%) differed significantly to type 2 diabetes (9.4%), whereas no significant difference was found in the presence of thyroglobulin antibodies.…”

“…A recent study showed the presence of thyroid peroxidase antibodies in LADA (22.1%) differed significantly to type 2 diabetes (9.4%), whereas no significant difference was found in the presence of thyroglobulin antibodies. 12 The association of autoimmune disease is explained by the spreading of T cell response to new determinants during the course of autoimmunity development. The phenomenon of recruitment of additional T cell epitopes has been reported.…”