Partial remission in Brazilian children and adolescents with type 1 diabetes. Association with a haplotype of class II human leukocyte antigen and synthesis of autoantibodies

Camilo, Daniela S.; Pradella, Fernando; Paulino, Maria Fernanda Vanti Macedo; Baracat, Emílio Carlos Elias; Lemos-Marini, Sofia Helena Valente de; Guerra, Gil; Pavin, Elizabeth João; Parisi, Candida; Longhini, Ana Leda; Marques, Sílvia Barbosa Dutra; Guariento, E. G.; Lieber, Sofia Rocha; Macedo, Carlos Fernando; Silva, Letícia Gama e; Farias, Alessandro S.; Santos, Leonilda Maria Barbosa dos; Volpini, Walkyria Mara Gonçalves

doi:10.1111/pedi.12999

Cited by 9 publications

(9 citation statements)

References 40 publications

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“…Like other authors, we noted a gradual decrease in the number of remitters with time ( 2 , 4 , 6 , 7 , 21 , 23 , 24 ). Merely 10% (12 patients) of children still had PR after 2 years from diagnosis, and in only a few cases, PR lasted more than 4 years, and we observed only one case with PR prolonged over 6 years.…”

Section: Discussionsupporting

confidence: 89%

Body mass index and partial remission in 119 children with type 1 diabetes—a 6-year observational study

Sokołowska-Gadoux,

Jarosz-Chobot,

Polanska

et al. 2023

Front. Endocrinol.

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Background/objectiveThis long-term study aimed to analyze the associations between BMI Z-score, HbA1c, and daily insulin requirement (DIR) and the prevalence and duration of partial remission (PR) in children and adolescents with type 1 diabetes (T1D).MethodsAfter retrieving retrospective data for 195 patients from their health records at 24, 48, and 72 months after T1D diagnosis, the study group was comprised of 119 (57 girls) children with a complete dataset for all 6 years. PR was defined according to the ISPAD guidelines. Analyses were carried out in the whole group and subgroups according to PR duration: no PR at all (NPR), PR lasting less than 2 years (PR < 2), and PR at least 2 years (PR ≥ 2).ResultsPR was observed in 63% of the patients (78.9% of overweight and 100% of obese patients). NPR patients showed the lowest mean initial BMI Z-score [−0.65 ± 1.29 vs. 0.02 ± 1.42, (PR < 2), p = 0.01 and vs. 0.64 ± 1.43 (PR ≥ 2), p = 0.17]. The dissimilarity in BMI across patients declined over time. Within the NPR group, the initial mean BMI Z-score significantly increased within the first 2 years (unadjusted p < 0.001) and remained constant afterward. In the PR <2 group, the highest increase in BMI Z-score occurred after 4 years (p < 0.001) and then decreased (p = 0.04). In the PR ≥2, the BMI Z-score slightly decreased within the first 2 years (p = 0.02), then increased (p = 0.03) and remained unchanged for the last 2 years. Six years after T1D started, the mean DIRs do not differ among the patient groups (ANOVA p = 0.272).ConclusionDuring 6 years of follow-up, PR occurred in almost two-thirds of the studied children including almost all overweight and obese children. We observed a gradual normalization of the BMI Z-score at the end of the follow-up. BMI Z-score increased slightly in children with no remission initially but remained later constant until the end of observation. In both remitter groups, the increase in BMI Z-score appeared later when the protective honeymoon period ended. Regardless of BMI Z-score, the β-cell destruction process progresses, and after 6 years, the DIR is similar for all patients.

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Section: Discussionsupporting

confidence: 89%

Body mass index and partial remission in 119 children with type 1 diabetes—a 6-year observational study

Sokołowska-Gadoux,

Jarosz-Chobot,

Polanska

et al. 2023

Front. Endocrinol.

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“…However, a recent report on PCR in Brazilian children and adolescents revealed that the presence of DRB1*03-DQB1*0201 alleles was more prevalent among patients entering remission. Interestingly, all patients carrying this HLA genotype had positivity for GADA at diagnosis, most of them as a single autoantibody [ 39 ]. This association between haplotype of class II human leukocyte antigen and synthesis of autoantibodies could partially explain our results, even though further studies to better investigate this topic are awaited.…”

Section: Discussionmentioning

confidence: 99%

Influence of Age on Partial Clinical Remission among Children with Newly Diagnosed Type 1 Diabetes

Passanisi

Salzano

Gasbarro

et al. 2020

IJERPH

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Partial clinical remission (PCR) is a transitory period characterized by the residual endogenous insulin secretion following type 1 diabetes (T1D) diagnosis and introducing the insulin therapy. Scientific interest in PCR has been recently increasing, as this phase could be crucial to preserve functional beta cells after T1D onset, also taking advantage of new therapeutic opportunities. The aim of this study was to assess the frequency, duration and associated factors of PCR in children newly diagnosed with T1D. Our cohort study included 167 pediatric patients aged 13.8 ± 4.1 years. The association of clinical and laboratory factors with the occurrence and duration of PCR was evaluated via logistic regression and multivariable generalized linear model, respectively. PCR occurred in 63.5% of the examined patients. Patients who achieved the remission phase were significantly older, and they had lower daily insulin requirement compared with non-remitters. PCR was positively associated to body mass index (OR = 1.11; p = 0.032), pH value (OR 49.02; p = 0.003) and c-peptide levels (OR 12.8; p = 0.002). The average duration of PCR was 13.4 months, and older age at diagnosis was the only predictor factor. Two years after diagnosis remitter patients had lower HbA1c and daily insulin requirement.

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“…9 Many studies have shown that the immune-related genetic susceptibility of the HLA system is associated with various diseases, and many HLA genes have also been reported to be associated with the RR of primary kidney disease. 12,13 Because of the random expression patterns and linkage imbalance of the HLA alleles, their genetic susceptibility differs in different geographic regions and nationalities. 14 In this study, the allele frequencies of HLA-A2, -B48, -B52, and -B55 were significantly higher in the case group than in the control group (p < 0.05), whereas that of HLA-B60 was significantly higher in the control group (p < 0.05), indicating that HLA-A2, -B48, -B52, and -B55 may be independent susceptibility alleles for ESRD in patients with primary nephropathy in Hunan Province.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that the immune‐related genetic susceptibility of the HLA system is associated with various diseases, and many HLA genes have also been reported to be associated with the RR of primary kidney disease. 12 , 13 Because of the random expression patterns and linkage imbalance of the HLA alleles, their genetic susceptibility differs in different geographic regions and nationalities. 14 …”

Section: Discussionmentioning

confidence: 99%

Association of end‐stage renal disease with HLA phenotypes and panel reactive antibodies in patients awaiting renal transplantation in Hunan Province

Lü

Sun

2022

Clinical Laboratory Analysis

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Kidney transplantation using organs from relatives or donors is one of the main treatment methods for patients with end-stage renal disease (ESRD). 1 Human leukocyte antigens (HLAs), which are cell-surface proteins encoded by the major histocompatibility complex in the human body, act mainly to regulate the immune response and immune regulatory functions. The HLA genes, which are highly polymorphic, determine the compatibility of transplanted tissue with the recipient's HLA phenotype, and their expression is closely

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Partial remission in Brazilian children and adolescents with type 1 diabetes. Association with a haplotype of class II human leukocyte antigen and synthesis of autoantibodies

Cited by 9 publications

References 40 publications

Body mass index and partial remission in 119 children with type 1 diabetes—a 6-year observational study

Body mass index and partial remission in 119 children with type 1 diabetes—a 6-year observational study

Influence of Age on Partial Clinical Remission among Children with Newly Diagnosed Type 1 Diabetes

Association of end‐stage renal disease with HLA phenotypes and panel reactive antibodies in patients awaiting renal transplantation in Hunan Province

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