© 2001 by the American Diabetes Association, Inc. Analysis of the Coding and Promoter Regions of the Autoantigen IA-2 in Subjects With and Without Autoantibodies to IA-2
1 Experimental Medicine Section, Oral Infection and Immunity Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
Despite extensive studies on HLA polymorphism, there have been few, if any, studies on allelic forms or mutations in proteins that serve as autoantigens. The present experiments were designed to look for alterations in the coding and promoter regions of the autoantigen IA-2 in type one (insulin-dependent) diabetic patients with autoantibodies to IA-2 as compared with siblings without diabetes or autoantibodies to IA-2. Genomic DNA was used as a template and was amplified by polymerase chain reaction, with pairs of primers encompassing the promoter region and the 23 exons of the coding region of IA-2. A total of nine nucleotide changes were found in the coding region of the six type 1 diabetic patients; four were silent and five were missense changes, but all occurred in the extracellular domain of IA-2 to which autoantibodies are not directed. Few, if any, changes were found in the 5' upstream (-706 to +135) promoter region. The results of the experiments support the null hypothesis that differences among individuals in the nucleotide and amino acid sequences of the promoter and coding regions of IA-2, respectively, do not account for why some individuals develop autoantibodies to IA-2 and others do not.
The immune response to an antigen requires the processing of that antigen into peptides. Processed peptides then bind to class I or II HLA molecules, and the complexes are presented to receptors on T-cells (1). The magnitude of the immune response is a function of antigen presentation, which in turn is dependent on antigen-binding to specific HLA molecules. Which peptides bind is defined by the amino acid sequence within the binding groove of the HLA molecule (2). The diversity of HLA alleles ensures a broad spectrum of immune responses within the population. Certain autoimmune diseases are known to be strongly linked to the HLA haplotype of an individual (3). One of the strongest linkages is with type 1 (insulin-dependent) diabetes (4,5). Individuals who are of the HLA-DQ and/or DR haplotype (i.e., the DRB1*0301, DRB1*0401, DQA1*0301, and/or DQB1*0302 alleles) are at a considerably higher risk of developing type 1 diabetes than individuals with other haplotypes, and >90% of type 1 diabetic patients are of the HLA-DQ and/or DR haplotype (4,6,7). In contrast, individuals who carry the HLA allele DQB1*0602 are at a considerably lower risk of developing type 1 diabetes, and the DQB1*0602 allele may in fact be protective (8). Susceptibility to type 1 diabetes can be influenced by the presence or absence of a single amino acid within the HLA molecule. For example, resistance to type 1 diabetes is strongly associated with an aspartic acid at position 57 of the HLA-DQß chain. When aspartic acid is not present at position 57, there is a significant increase in the risk of type 1 diabetes (9,10). Despite extensive studies on HLA molecules, very little consideration has been given to the possibility that there might be distinct alleles encoding proteins that act as autoantigens, and that this could result in differences in the amino acid composition of the autoantigens. If such allelic differences exist, the processed autoantigenic peptides might fit better into specific HLA grooves and thereby make the triggering of an autoimmune response more likely. This might account for why some individuals develop autoantibodies to an antigen and others do not. Similarly, polymorphisms in the promoter region might result in aberrant expression of an autoantigen and thereby increase the likelihood of triggering an autoimmune response. Despite these possibilities, the nucleotide sequence of the coding and promoter regions of autoantigens in patients with and without autoantibodies has not been studied.
IA-2, a member of the protein tyrosine phosphatase family, is a major autoantigen in type 1 diabetes (11). Of all newly diagnosed type 1 diabetic patients,
To look for alterations in IA-2 that might account for the development of IA-2 autoantibodies, genomic DNA from six IA-2 autoantibodypositive type 1 diabetic patients was used as template. Seven pairs of primers covering the 23 exons of the coding region of IA-2 were prepared (Table 1 and Fig. 1) and used to amplify IA-2 genomic DNA by polymerase chain reaction (PCR). The size of the PCR products for each of the regions amplified (Fig. 1) corresponded to the expected sizes. The PCR products were then cloned, sequenced, and compared with the sequence of IA-2 from nondiabetic siblings and normal control data in the GenBank (accession no. AF042285 and Q16849). As seen in Table 2, a total of nine nucleotide substitutions were found, resulting in five amino acid changes. Seven of the nine nucleotide substitutions were found in different exons. In three of the patients, a nucleotide substitution was found in exon 5, but each was located at a different position, and two resulted in a conserved amino acid change (patient 3, A169
Recently, we determined the sequence of the proximal 5' upstream region of IA-2 and showed that it possessed promoter activity (15). In the current study, primer 1, which encompasses this region (-706 nt to +135 nt, including exon 1), was used to amplify the genomic DNA of diabetic and nondiabetic subjects by PCR, and the PCR products were sequenced. The DNA from the six nondiabetic autoantibody-negative subjects revealed identical sequences (GenBank accession no. AF042258), but showed several nucleotide changes compared with the sequence originally reported (GenBank accession no. gi:2801767). The sequence of the DNA from the six diabetic autoantibody-positive subjects was identical to that of the nondiabetic autoantibody-negative subjects. In the distal 5' upstream region (-688 nt to -3,091 nt), using four pairs of primers (AD) (Table 1 and Fig. 1), three Alu consensus sequences (i.e., A, B, and C) were found (GenBank accession no. AF042285) that belong to the Alu subfamily Sb (17). As expected, Alu polymorphisms were detected in both normal subjects and diabetic patients (Table 3), but the frequency is still not known, and the significance, if any, of these polymorphisms at such a long distance from the IA-2 promoter or coding regions is uncertain.
Mutations in the promoter region of specific genes or the transcription factors that interact with these genes can influence the time and magnitude of protein expression (18,19,20). In the present study, we failed to find any significant changes in the proximal 5' upstream region of IA-2 in type 1 diabetic patients. This argues that alterations in the promoter region are not responsible for the aberrant expression of IA-2, which might trigger the development of IA-2 autoantibodies. The idea that alterations in transcription factors expressed in diabetes-prone individuals, but not in control subjects, also might affect the time and magnitude of IA-2 expression, remains to be investigated. We conclude that neither allelic forms of IA-2 nor mutations in the coding or promoter regions of the IA-2 gene are responsible for triggering autoantibodies to IA-2. Thus, at least in the case of one autoimmune disease, type 1 diabetes, the results presented here support the null hypothesis that differences in the amino acid sequence of the autoantigen do not explain why some individuals develop autoimmune disease and others do not.
Subjects. Genomic DNA was obtained from six diabetic and six nondiabetic subjects (three male and three female subjects in each group) from the Human Biological Data Interchange (HBDI, Philadelphia, PA). The subjects came from families with two or more siblings with type 1 diabetes and at least one sibling without diabetes. The diabetic subjects ranged in age from 2 to 12 years, and five of the six that were genotyped were HLA-DRB1*0301 or 0401 or DQB1*0302. The genotypes of the nondiabetic siblings varied considerably, and were HLA DRB1*0701, *1501, *0401, and *0302 and DQB1*02, *0602, *0302, *0301, and *0402. All six diabetic patients, but none of the nondiabetic siblings, had autoantibodies to IA-2, as determined by radioimmune precipitation of recombinant IA-2 (21). For the single-strand conformation polymorphism studies, we used genomic DNA from 190 patients with type 1 diabetes and 190 unrelated control subjects of Caucasian origin collected from North-Central Florida (22).
Cloning and sequencing of coding and 5' upstream regions of human IA-2.
Address correspondence and reprint requests to Dr. Abner Louis Notkins, National Institutes of Health, Bldg. 30, Rm. 121, 30 Convent Dr. MSC 4322, Bethesda, MD 20892-4322. E-mail: anotkins{at}dir.nidcr.nih.gov. Received for publication 5 October 2000 and accepted in revised form 8 July 2001. PCR, polymerase chain reaction.
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