Clinical and Immunologie Studies of HLA-DR Typed Insulin-Dependent Diabetics — a Mini-Review

Summary

There is strong association between insulin-dependent (type I) diabetes and the HLA DR3 and/or DR4 factors. Also, evidence has been accumulated that an immune response gene associated to the DR3 region may be a denominator for the development of an endocrine autoimmunity. It is particularly the late onset type I diabetes that belongs to the so-called “primary” autoimmune variety and also shows an increased tendency for the development of other autoimmune disorders. HLA DR 3 and/or HLA DR 4 associated mechanisms seem to influence a variety of clinical and immunologic findings in type I diabetes. Basically, this concept is supported by findings on seasonal variations in diabetes manifestation, on viral antibodies, on anti-insulin antibody formation, and on the natural course of endogenous insulin secretion in relation to HLA haptotypes. There are, however, conflicting data concerning islet cell antibodies, circulating immune complexes, and the incidence of diabetic microangiopathy in relation to the HLA-system. Many of these findings may be explained on the basis of an HLA heterogeneity. But this does not necessarily point to an etiological genetic heterogeneity of type I diabetes.

Key words

Type I diabetes - immune genetic - HLA-factors