AUTHOR=Frommer Lara , Kahaly George J. 

TITLE=Type 1 Diabetes and Autoimmune Thyroid Disease—The Genetic Link

JOURNAL=Frontiers in Endocrinology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.618213

DOI=10.3389/fendo.2021.618213

ISSN=1664-2392

ABSTRACT=<p>Type 1 diabetes (T1D) and autoimmune thyroid disease (AITD) are the most frequent chronic autoimmune diseases worldwide. Several autoimmune endocrine and non-endocrine disorders tend to occur together. T1D and AITD often cluster in individuals and families, seen in the formation of autoimmune polyendocrinopathy (AP). The close relationship between these two diseases is largely explained by sharing a common genetic background. The HLA antigens DQ2 (<italic>DQA1*0501-DQB1*0201</italic>) and DQ8 (<italic>DQA1*0301-DQB1*0302</italic>), tightly linked with DR3 and DR4, are the major common genetic predisposition. Moreover, functional single nucleotide polymorphisms (or rare variants) of various genes, such as the <italic>cytotoxic T-lymphocyte- associated antigen (CTLA4)</italic>, the <italic>protein tyrosine phosphatase non-receptor type 22 (PTPN22)</italic>, the <italic>interleukin-2 Receptor (IL2Ra)</italic>, the <italic>Vitamin D receptor (VDR)</italic>, and the <italic>tumor-necrosis-factor-α (TNF)</italic> that are involved in immune regulation have been identified to confer susceptibility to both T1D and AITD. Other genes including cluster of differentiation <italic>40 (CD40)</italic>, the <italic>forkhead box P3 (FOXP3)</italic>, the <italic>MHC</italic> Class I <italic>Polypeptide-Related Sequence A (MICA)</italic>, <italic>insulin variable number of tandem repeats (INS-VNTR)</italic>, the <italic>C-Type Lectin Domain Containing 16A (CLEC16A)</italic>, the <italic>Erb-B2 Receptor Tyrosine Kinase 3 (ERBB3)</italic> gene, the <italic>interferon-induced helicase C domain-containing protein 1 (IFIH1)</italic>, and various cytokine genes are also under suspicion to increase susceptibility to T1D and AITD. Further, <italic>BTB domain and CNC homolog 2</italic> (<italic>BACH2)</italic>, <italic>C-C motif chemokine receptor 5</italic> (<italic>CCR5)</italic>, <italic>SH2B adaptor protein 3</italic> (<italic>SH2B3)</italic>, and <italic>Rac family small GTPase 2</italic> (<italic>RAC2)</italic> are found to be associated with T1D and AITD by various independent genome wide association studies and overlap in our list, indicating a strong common genetic link for T1D and AITD. As several susceptibility genes and environmental factors contribute to the disease aetiology of both T1D and AITD and/or AP subtype III variant (T1D+AITD) simultaneously, all patients with T1D should be screened for AITD, and vice versa.</p>