Background: It has been reported that HLA class II haplotypes DRB1*0405-DQA1*0303-DQB1*0401 and DRB1*0901-DQA1*0302-DQB1*0303 are major susceptibility haplotypes for type 1 diabetes mellitus (DM) in Japanese population. However, little has been reported on the susceptibility HLA class II haplotypes in Japanese patients with autoimmune polyglandular syndrome type II and type III (APS III). Patients and Methods: HLA class II haplotypes of DRB1-DQA1-DQB1 in 31 patients with APS III, 14 patients with Hashimoto’s thyroiditis alone, and 15 patients with Graves’ disease alone were examined in Japanese population. APS III patients were divided into three groups (A, B, and C) depending on the combination of autoimmune endocrine diseases. Results: In 13 APS III patients with both Hashimoto’s thyroiditis and type 1 DM (group A), the haplotype frequencies of the HLA DRB1*0802-DQA1*0401-DQB1*0402 and DRB1*0901-DQA1*0302-DQB1*0303 were significantly higher than in the controls. In patients with Hashimoto’s thyroiditis alone, the haplotype frequency of DRB1*0901-DQA1*0302-DQB1*0303 was significantly higher than in controls, whereas the frequency of DRB1*0802-DQA1*0401-DQB1*0402 did not differ significantly from those in the controls. In 11 APS III patients with both Graves’ disease and type 1 DM (group B), the haplotype frequencies of HLA DRB1*0405-DQA1*0303-DQB1*0401 and DRB1*0802-DQA1*0301-DQB1*0302 were significantly higher than in controls. In patients with Graves’ disease alone, the haplotype frequency of DRB1*0803-DQA1*0103-DQB1*0601 were significantly higher than those in controls, suggesting that the susceptibility haplotypes for group B APS III differed from those for Graves’ disease alone. In 7 APS III patients with both autoimmune thyroid diseases and pituitary disorders (group C), the haplotype frequency of HLA DRB1*0405-DQA1*0303-DQB1*0401 was significantly higher than in controls. Conclusions: Susceptible HLA class II haplotypes of DRB1-DQA1-DQB1 for APS III differ between the Japanese and Caucasian populations. More interestingly, the susceptible HLA class II haplotypes differ among the three types of Japanese APS III and are not merely a combination of susceptibility haplotypes of each endocrine disease.

1.
Neufeld M, Maclaren N, Blizzard, R: Autoimmune polyglandular syndromes. Pediatr Ann 1980;9:154–162.
2.
Neufeld M, Maclaren NK, Blizzard RM: Two types of autoimmune Addison’s disease associated with different polyglandular autoimmune (PGA) syndromes. Medicine (Baltimore) 1982;60:355–362.
3.
Ahonen P: Autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED): autosomal recessive inheritance. Clin Genet 1985;27:535–542.
4.
Ahonen P, Myllarniemi S, Sipila I, Perheentupa J: Clinical variation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in a series of 68 patients. N Engl J Med 1990;322:1829–1836.
5.
Nagamine K, Peterson P, Scott HS, Kudoh J, Minoshima S, Heino M, Krohn KJ, Lalioti MD, Mullis PE, Antonarakis SE, Kawasaki K, Asakawa S, Ito F, Shimizu N: Positional cloning of the APECED gene. Nat Genet 1997;17:393–398.
6.
Finnish-German APECED Consortium: An autoimmune disease, APECED, caused by mutations in a novel gene featuring two PHD-type zinc finger domains. Nat Genet 1997;17:399–403.
7.
Badenhoop K, Walfish PG, Rau H, Fischer S, Nicolay A, Bogner U, Schleusener H, Usadel KH: Susceptibility and resistance alleles of human leukocyte antigen (HLA) DQA1 and HLA DQB1 are shared in endocrine autoimmune disease. J Clin Endocrinol Metab 1995;80:2112–2117.
8.
Tait KF, Gough CL: The genetics of autoimmune endocrine disease. Clin Endocrinol (Oxf) 2003;59:1–11.
9.
Cucca F, Todd J: HLA susceptibility to type 1 diabetes: methods and mechanisms; in Browning MJ, McMichael AJ (eds): HLA and MHC: Genes, Molecules, and Function. Oxford, BIOS Scientific, 1996, pp 383–406.
10.
Cavan DA, Penny MA, Jacobs KH, Kelly MA, Jankins D, Mijovic C, Chow C, Cockram CS, Hawkins BR, Barnett AH: The HLA association with Graves’ disease is sex-specific in Hong Kong Chinese subjects. Clin Endocrinol (Oxf) 1994;40:63–66.
11.
Yanagawa T, Mangklabruks A, DeGroot L: Strong association between HLA-DQA1*0501 and Graves’ disease in a male Caucasian population. J Clin Endocrinol Metab 1994;79:227–229.
12.
Yanagawa T, Hidaka Y, Guimaraes V, Soliman M, DeGroot, LJ: CTLA-4 gene polymorphism associated with Graves’ disease in a Caucasian population. J Clin Endocrinol Metab 1995;80:41–45.
13.
Barlow ABT, Wheatcroft N, Watson P, Weetman AP: Association of HLA-DQA1*0501 with Graves’ disease in English Caucasian men and women. Clin Endocrinol (Oxf) 1996;44:73–77.
14.
Brix TH, Kyvik KO, Hegedus L: What is the evidence of genetic factors in the etiology of Graves’ disease? A brief review. Thyroid 1998;8:627–634.
15.
Tanaka S, Okubo K, Kobayashi T, Murase T, Nakanishi K, Odawara M, Koyama R, Inoko H: Association of HLA-DQ genotype in autoantibody-negative and rapid-onset type 1 diabetes. Diabetes Care 2002;25:2302–2307.
16.
Kawabata Y, Ikegami H, Kawaguchi Y, Fujisawa T, Shintani M, Ono M, Nishino M, Uchigata Y, Lee I, Ogihara T: Asian-specific HLA haplotypes reveal heterogeneity of the contribution of HLA-DR and -DQ haplotypes to susceptibility to type 1 diabetes. Diabetes 2002;51:545–551.
17.
Myhre AG, Undlien DE, Lovas K, Uhlving S, Nedrebo BG, Fougner J, Trovik T, Sorheim JI, Husebye ES: Autoimmune adrenocortical failure in Norway autoantibodies and human leukocyte antigen class II associations related to clinical features. J Clin Endocrinol Metab 2002;87:618–623.
18.
Myhre AG, Aarsetoy H, Undien DE, Hovdenak N, Aksnes L, Husebye E: High frequency of celiac disease among patients with autoimmune adrenocortical failure. Scand J Gastroenterol 2003;38:511–515.
19.
Takao T, Nanamiya W, Matsumoto R, Asaba K, Okabayashi T, Hashimoto K: Antipituitary antibodies in patients with lymphocytic hypophysitis. Horm Res 2001;55:288–292.
20.
Czachurski D, Scherer S, Gehrke S, Laux G, Opelz G, Mytilineos J: Identification of two new HLA alleles: B:3546* and B:5611*. How reliable are the published HLA-B intron 2 sequences? Tissue Antigens 2004;64:500–505.
21.
Hashimoto M, Kinoshita T, Yamasaki M, Tanaka H, Imanishi T, Ihara H, Ichikawa Y, Fukunishi T: Gene frequencies and haplotype associations within the HLA in 916 unrelated Japanese individuals. Tissue Antigens 1994;44:166–173.
22.
Nakajima T, Nakamura J, Yokota T: Analysis of HLA haplotypes in Japanese, using high resolution allele typing. J Jpn Soc Histocompat Immunogen 2001;8:1–32.
23.
Kosta K, Watson PF, Weetman AP: A CTLA-4 gene polymorphism is associated with both Graves’ disease and autoimmune hypothyroidism. Clin Endocrinol (Oxf) 1997;46:551–554.
24.
Donner H, Braun J, Seidl C, Rau H, Finke R, Ventz M, Walfish PG, Usadel KH, Badenhoop K: Codon 17 polymorphism of the cytotoxic T lymphocyte antigen 4 gene in Hashimoto’s thyroiditis and Addison’s disease. J Clin Endocrinol Metab 1997;82:4130–4132.
25.
Vaidya B, Imrie H, Perros P, Young ET, Kelly WF, Carr D, Large DM, Toft AD, McCarthy MI, Kendall-Taylor P, Pearce SH: The cytotoxic T lymphocyte antigen-4 is a major Graves’ disease locus. Hum Mol Genet 1999;8:1195–1199.
26.
Heward JM, Allahabadia A, Armitage M, Dodson PM, Macleod K, Carr-Smith J, Daykin J, Daly A, Sheppard MC, Holder RL, Barnett AH, Franklyn JA, Gouh SC: The development of Graves’ disease and the CTLA-4 gene on chromosome 2q33. J Clin Endocrinol Metab 1999;84:2398–2401.
27.
Kriegel MA, Lohmann T, Gabler C, Blank N, Kalden JR, Lorenz H-M: Defective suppressor function of human CD4+ CD25+ regulatory T cells in autoimmune polyglandular syndrome type II. J Exp Med 2004;199:1285–1291.
28.
Dong RP, Kimura A, Okubo R, Shinagawa H, Tamai H, Nishimura Y, Sasazuki T: HLA-A and DPB1 loci confer susceptibility to Graves’ disease. Hum Immunol 1992;35:165–172.
29.
Yanagawa T, Mangklabruks A, Chang YB, Okamoto Y, Fisfallen ME, Curren PG, DeGroot LJ: Human histocompatibility leukocyte antigen-DQA1*0501 allele associated with genetic susceptibility to Graves’ disease in a Caucasian population. J Clin Endocrinol Metab 1993;76:1569–1574.
30.
Wallaschofski H, Meyer A, Tuschy U, Lohmann T: HLA-DQA1*0301-associated susceptibility for autoimmune polyglandular syndrome type II and III. Horm Metab Res 2003;35:120–124.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.