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  • Type 1 diabetes (T1D) is an autoimmune disease characterized by the lack of insulin due to an autoimmune destruction of pancreatic beta cells. Here, we report a unique case of a family with naturally conceived quadruplets in which T1D was diagnosed in two quadruplets simultaneously. At the same time, the third quadruplet was diagnosed with the pre-diabetic stage. Remarkably, all four quadruplets were positive for anti-islet cell antibodies, GAD65 and IA-A2. Monozygotic status of the quadruplets was confirmed by testing 14 different short tandem repeat polymorphisms. Serological examination confirmed that all quadruplets and their father suffered from a recent enteroviral infection of EV68-71 serotype. To assess the nature of the molecular pathological processes contributing to the development of diabetes, immunocompetent cells isolated from all family members were characterized by gene expression arrays, immune-cell enumerations and cytokine-production assays. The microarray data provided evidence that viral infection, and IL-27 and IL-9 cytokine signalling contributed to the onset of T1D in two of the quadruplets. The propensity of stimulated immunocompetent cells from non-diabetic members of the family to secrete high level of IFN-alpha further corroborates this conclusion. The number of T regulatory cells as well as plasmacytoid and/or myeloid dendritic cells was found diminished in all family members. Thus, this unique family is a prime example for the support of the so-called 'fertile-field' hypothesis proposing that genetic predisposition to anti-islet autoimmunity is 'fertilized' and precipitated by a viral infection leading to a fully blown T1D.
  • Type 1 diabetes (T1D) is an autoimmune disease characterized by the lack of insulin due to an autoimmune destruction of pancreatic beta cells. Here, we report a unique case of a family with naturally conceived quadruplets in which T1D was diagnosed in two quadruplets simultaneously. At the same time, the third quadruplet was diagnosed with the pre-diabetic stage. Remarkably, all four quadruplets were positive for anti-islet cell antibodies, GAD65 and IA-A2. Monozygotic status of the quadruplets was confirmed by testing 14 different short tandem repeat polymorphisms. Serological examination confirmed that all quadruplets and their father suffered from a recent enteroviral infection of EV68-71 serotype. To assess the nature of the molecular pathological processes contributing to the development of diabetes, immunocompetent cells isolated from all family members were characterized by gene expression arrays, immune-cell enumerations and cytokine-production assays. The microarray data provided evidence that viral infection, and IL-27 and IL-9 cytokine signalling contributed to the onset of T1D in two of the quadruplets. The propensity of stimulated immunocompetent cells from non-diabetic members of the family to secrete high level of IFN-alpha further corroborates this conclusion. The number of T regulatory cells as well as plasmacytoid and/or myeloid dendritic cells was found diminished in all family members. Thus, this unique family is a prime example for the support of the so-called 'fertile-field' hypothesis proposing that genetic predisposition to anti-islet autoimmunity is 'fertilized' and precipitated by a viral infection leading to a fully blown T1D. (en)
Title
  • Case report: type 1 diabetes in monozygotic quadruplets
  • Case report: type 1 diabetes in monozygotic quadruplets (en)
skos:prefLabel
  • Case report: type 1 diabetes in monozygotic quadruplets
  • Case report: type 1 diabetes in monozygotic quadruplets (en)
skos:notation
  • RIV/68378050:_____/12:00376318!RIV13-AV0-68378050
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • P(2B06019), P(2B08066), P(GAP302/10/1679), Z(AV0Z50520514), Z(MSM0021620812), Z(MZ0FNM2005)
http://linked.open...iv/cisloPeriodika
  • 4
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 126055
http://linked.open...ai/riv/idVysledku
  • RIV/68378050:_____/12:00376318
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • autoimmunity; type 1 diabetes; beta cells (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • GB - Spojené království Velké Británie a Severního Irska
http://linked.open...ontrolniKodProRIV
  • [520C7BBE9ECC]
http://linked.open...i/riv/nazevZdroje
  • European Journal of Human Genetics
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
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http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 20
http://linked.open...iv/tvurceVysledku
  • Šedivá, A.
  • Neuwirth, Aleš
  • Filipp, Dominik
  • Faresjo, M.
  • Halbhuber, Z.
  • Hubáčková, M.
  • Kayserová, J.
  • Koloušková, S.
  • Petruželková, L.
  • Spíšek, R.
  • Sumnik, Z.
  • Ulmannová, T.
  • Včeláková, J.
  • Štechová, K.
http://linked.open...ain/vavai/riv/wos
  • 000301736600015
http://linked.open...n/vavai/riv/zamer
issn
  • 1018-4813
number of pages
http://bibframe.org/vocab/doi
  • 10.1038/ejhg.2011.212
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