Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The association between the HLA-G 14-bp insertion/deletion polymorphism and type 1 diabetes

Abstract

Type 1 diabetes (T1D) is a multifactorial disease that has a strong genetic component. The HLA-G is a nonclassical HLA class I locus that is associated with immunomodulatory functions, including downregulation of innate and adaptive immune responses and induction of immune tolerance. However, there is currently limited information about the involvement of HLA-G in T1D susceptibility. This case-control study aims to investigate the T1D susceptibility association of alleles and genotypes of a widely investigated 14-bp insertion/deletion polymorphism in the HLA-G and to provide further evidence of the frequency distribution of class II HLA-DR-DQ-risk genotypes in T1D children and adolescents in the Brazilian population. The deletion allele and the homozygous deletion genotype are associated with susceptibility to T1D and the insertion allele and the heterozygous deletion/insertion genotype are associated with protection from T1D. We also confirm that genetic susceptibility to T1D is associated with the DRB1*03:01-DQA1*05:01-DQB1*02:01 and DRB1*04-DQA1*03:01-DQB1*03:02 haplotypes in Brazilian northeast region. The DR3-DQ2/DR4-DQ8 genotype conferred the highest detected risk for T1D. Our results identify a novel association of the 14-bp deletion allele and the homozygous deletion genotype with T1D development and provide additional evidence of the importance of HLA class II heterozygous DR3-DQ2/DR4-DQ8 genotype in T1D susceptibility.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Care M . Standards of medical care in diabetes-2013. Diabetes Care 2013; 36 (Suppl 1): S11–S66.

    Google Scholar 

  2. Emery LM, Babu S, Bugawan TL, Norris JM, Erlich HA, Eisenbarth GS et al. Newborn HLA-DR, DQ genotype screening: age- and ethnicity-specific type 1 diabetes risk estimates. Pediatr Diabetes 2005; 6: 136–144.

    Article  PubMed  Google Scholar 

  3. Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G, EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005-20: a multicentre prospective registration study. Lancet 2009; 373: 2027–2033.

    Article  PubMed  Google Scholar 

  4. Caillat-zucman S, Garchon H, Timsit J, Assan R, Boitard C, Djilali-saiah I et al. Age-dependent HLA genetic heterogeneity of type 1 insulin-dependent diabetes mellitus. J Clin Invest 1992; 90: 2242–2250.

    Article  CAS  PubMed  Google Scholar 

  5. Lambert A, Gillespie K, Thomson G, Cordell H, Todd J, Gale EAM et al. Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. J Clin Endocrinol Metab 2004; 89: 4037–4043.

    Article  CAS  PubMed  Google Scholar 

  6. Leslie RD . Predicting adult-onset autoimmune diabetes: clarity from complexity. Diabetes 2010; 59: 330–331.

    Article  CAS  PubMed  Google Scholar 

  7. Moustakas AK, Papadopoulos GK . Molecular properties of HLA-DQ alleles conferring susceptibility to or protection from insulin-dependent diabetes mellitus: keys to the fate of islet beta-cells. Am J Med Genet 2002; 115: 37–47.

    Article  PubMed  Google Scholar 

  8. Van Lummel M, van Veelen PA, Zaldumbide A, de Ru A, Janssen GMC, Moustakas AK et al. Type 1 diabetes-associated HLA-DQ8 transdimer accommodates a unique peptide repertoire. J Biol Chem 2012; 287: 9514–9524.

    Article  CAS  PubMed  Google Scholar 

  9. Eike MC, Becker T, Humphreys K, Olsson M, Lie BA . Conditional analyses on the T1DGC MHC dataset: novel associations with type 1 diabetes around HLA-G and confirmation of HLA-B. Genes Immun 2009; 10: 56–67.

    Article  CAS  PubMed  Google Scholar 

  10. Teixeira AC, Souza FF, Marano LA, Deghaide NHS, Ferreira SC . The 14 bp-deletion allele in the HLA-G gene confers susceptibility to the development of hepatocellular carcinoma in the Brazilian population. Tissue Antigens 2013; 81: 408–413.

    Article  CAS  PubMed  Google Scholar 

  11. Martelli-palomino G, Pancotto JA, Muniz YC, Mendes-junior CT, Erick C, Massaro JD et al. Polymorphic sites at the 3’ untranslated region of the HLA-G gene are associated with differential HLA-G soluble levels in the Brazilian and French population. PLoS One 2013; 8: e71742.

    Article  CAS  PubMed  Google Scholar 

  12. Carosella ED, Favier B, Rouas-freiss N, Moreau P, Lemaoult J, Bm I . Beyond the increasing complexity of the immunomodulatory HLA-G molecule. Blood 2008; 111: 4862–4870.

    Article  CAS  PubMed  Google Scholar 

  13. Abediankenari S, Eslami MB, Sarrafnejad A, Mohseni M . Dendritic cells bearing HLA-G inhibit T-cell activation in type 1 diabetes. Iran J Allergy Asthma Immunol 2007; 6: 1–7.

    CAS  PubMed  Google Scholar 

  14. Blaschitz A, Crisa L, Schmitt C, Fournel S, King A, Loke YW et al. HLA-G in the human thymus: a subpopulation of medullary epithelial but not CD83 (+) dendritic cells expresses HLA-G as a membrane-bound and soluble protein. Int Immunol 1999; 11: 889–898.

    Article  PubMed  Google Scholar 

  15. Cirulli V, Zalatan J, Mcmaster M, Prinsen R, Salomon DR, Ricordi C et al. The class I HLA repertoire of pancreatic islets comprises the nonclassical class Ib antigen HLA-G. Diabetes 2006; 55: 1214–1222.

    Article  CAS  PubMed  Google Scholar 

  16. Castelli EC, Veiga-castelli LC, Yaghi L, Moreau P, Donadi EA . Transcriptional and posttranscriptional regulations of the HLA-G Gene. J Immunol Res 2014; 2014: 734068.

    Article  PubMed  Google Scholar 

  17. Amodio G, De Albuquerque RS, Gregori S . New insights into HLA-G mediated tolerance. Tissue Antigens 2014; 84: 255–263.

    Article  CAS  PubMed  Google Scholar 

  18. Twito T, Joseph J, Mociornita A, Rao V, Ross H, Delgado DH . The 14-bp deletion in the HLA-G gene indicates a low risk for acute cellular rejection in heart transplant recipients. J Heart Lung Transplant 2011; 30: 778–782.

    Article  PubMed  Google Scholar 

  19. Misra MK, Prakash S, Kapoor R, Pandey SK, Sharma RK, Agrawal S . Association of HLA-G promoter and 14-bp insertion – deletion variants with acute allograft rejection and end-stage renal. Tissue Antigens 2013; 82: 317–326.

    Article  CAS  PubMed  Google Scholar 

  20. Borghi A, Rizzo R, Corazza M, Bertoldi AM, Bortolotti D, Sturabotti G et al. HLA-G 14-bp polymorphism: a possible marker of systemic treatment response in psoriasis vulgaris? Preliminary results of a retrospective study. Dermatol Ther 2014; 27: 284–289.

    Article  PubMed  Google Scholar 

  21. Lee YH, Bae SC, Song SG . Meta-analysis of associations between functional HLA-G polymorphisms and susceptibility to systemic lupus erythematosus and rheumatoid arthritis. Rheumatol Int 2015; 35: 953–961.

    Article  CAS  PubMed  Google Scholar 

  22. Courtin D, Milet J, Sabbagh A, Massaro JD, Castelli EC, Jamonneau V et al. Infection, genetics and evolution HLA-G 3 0 UTR-2 haplotype is associated with human African trypanosomiasis susceptibility. Infect Genet Evol 2013; 17: 1–7.

    Article  CAS  PubMed  Google Scholar 

  23. Xu H, Shi W, Lin A, Yan W . HLA-G 3′ untranslated region polymorphisms influence the susceptibility for human papillomavirus infection. Tissue Antigens 2014; 84: 216–222.

    Article  CAS  PubMed  Google Scholar 

  24. Haddad R, Cilião Alves DC, Rocha-Junior MC, Azevedo R, Pombo-de-Oliveira MS, Takayanagui OM et al. HLA-G 14-bp Insertion/Deletion Polymorphism Is a Risk Factor for HTLV-1 Infection. AIDS Res Hum Retroviruses 2011; 27: 283–288.

    Article  CAS  PubMed  Google Scholar 

  25. Veit TD, Vianna P, Xavier RM, Delgado-can A, Gutierrez JE, Carneiro AP et al. Association of the HLA-G 14-bp insertion/deletion polymorphism with juvenile idiopathic arthritis and rheumatoid arthritis. Tissue Antigens 2008; 71: 440–446.

    Article  CAS  PubMed  Google Scholar 

  26. Fabris A, Segat L, Catamo E, Morgutti M, Vendramin A, Crovella S . HLA-G 14 bp deletion/insertion polymorphism in celiac disease. Am J Gastroenterol 2010; 106: 139–144.

    Article  PubMed  Google Scholar 

  27. Jeong KH, Kim SK, Kang BK, Chung JH, Shin MK, Lee MH . Association between an HLA-G 14 bp insertion/deletion polymorphism and non-segmental vitiligo in the Korean population. Arch Dermatol Res 2014; 306: 577–582.

    Article  CAS  PubMed  Google Scholar 

  28. Xue S, Yang J, Yao F, Xu L, Fan L, Fan L . Recurrent spontaneous abortions patients have more 1 14 bp heterozygotes in the 3 # UT region of the HLA-G gene in a Chinese Han population. Tissue Antigens 2007; 69: 153–155.

    Article  CAS  PubMed  Google Scholar 

  29. Steck AK, Rewers MJ . Genetics of type 1 diabetes. Clin Chem 2011; 57: 176–185.

    Article  CAS  PubMed  Google Scholar 

  30. Thomson G, Valdes AM, Noble JA, Kockum I, Grote MN, Najman J et al. Relative predispositional effects of HLA class II DRB1-DQB1 haplotypes and genotypes on type 1 diabetes: a meta-analysis. Tissue Antigens 2007; 70: 110–127.

    Article  CAS  Google Scholar 

  31. Valdes AM, Erlich HA, Carlson J, Varney M, Moonsamy PV, Noble JA . Use of class I and class II HLA loci for predicting age at onset of type 1 diabetes in multiple populations. Diabetologia 2012; 55: 2394–2401.

    Article  CAS  PubMed  Google Scholar 

  32. Nejentsev S, Howson JMM, Walker NM, Szeszko J, Sarah F, Stevens HE et al. Localization of type 1 diabetes susceptibility to the MHC class I genes HLA-B and HLA-A. Nature 2007; 450: 887–892.

    Article  CAS  PubMed  Google Scholar 

  33. With C, Ii RC, Lipponen K, Gombos Z, Kiviniemi M, Siljander H et al. Effect of HLA class I and class II alleles on progression from autoantibody positivity to overt type 1 diabetes in children with risk-associated class II genotypes. Diabetes 2010; 59: 3253–3256.

    Article  Google Scholar 

  34. Castelli EC, Moreau P, Oya A, Mendes-junior CT, Antonio E . In silico analysis of microRNAS targeting the HLA-G 3=untranslated region alleles and haplotypes. Hum Immunol 2009; 70: 1020–1025.

    Article  CAS  PubMed  Google Scholar 

  35. Lucena-Silva N, de Souza VS, Gomes RG, Fantinatti A, Muniz YC, de Albuquerque RS et al. HLA-G 3′ untranslated region polymorphisms are associated with systemic lupus erythematosus in 2 Brazilian populations. J Rheumatol 2013; 40: 1104–1113.

    Article  CAS  PubMed  Google Scholar 

  36. Tureck LV, Santos LC, Wowk PF, Mattar SB, Silva JS, Roxo VMMS et al. HLA-G 5 ′ URR SNPs and 3 ′ UTR 14-bp insertion/deletion polymorphism in an Afro-Brazilian population from Parana State. Int J Immunogenet 2014; 41: 29–33.

    Article  CAS  PubMed  Google Scholar 

  37. Goul S, Hantash BM, Zhao L, Faber C, Bzorek M, Holst M et al. The expression and functional activity of membrane-bound human leukocyte antigen-G1 are influenced by the 3 0 -untranslated region. Hum Immunol 2013; 74: 818–827.

    Article  Google Scholar 

  38. Rizzo R, Hviid TVF, Govoni M, Padovan M, Rubini M, Melchiorri L et al. HLA-G genotype and HLA-G expression in systemic lupus erythematosus: HLA-G as a putative susceptibility gene in systemic lupus erythematosus. Tissue Antigens 2008; 71: 520–529.

    Article  CAS  PubMed  Google Scholar 

  39. Rizzo R, Rubini M, Govoni M, Padovan M, Melchiorri L, Stignani M et al. HLA-G 14-bp polymorphism regulates the methotrexate response in rheumatoid arthritis. Pharmacogenet Genomics 2006; 16: 615–623.

    Article  CAS  PubMed  Google Scholar 

  40. Rizzo R, Bortolotti D, Ben N, Rotola A, Cura F, Castellazzi M et al. Role of HLA-G 14 bp deletion/insertion and+3142C>G polymorphisms in the production of sHLA-G molecules in relapsing-remitting multiple sclerosis. Hum Immunol 2012; 73: 1140–1146.

    Article  CAS  PubMed  Google Scholar 

  41. García-gonzález IJ, Valle Y, Rivas F, Figuera-villanueva LE, Muñoz-valle JF, Flores-salinas HE et al. The 14 bp Del/Ins HLA-G polymorphism is related with high blood pressure in acute coronary syndrome and type 2 diabetes mellitus. Biomed Res Int 2014; 2014: 898159.

    Article  PubMed  Google Scholar 

  42. Solini A, Muscelli E, Stignani M, Melchiorri L, Santini E, Rossi C et al. Soluble human leukocyte antigen-G expression and glucose tolerance in subjects with different degrees of adiposity. J Clin Endocrinol Metab 2010; 95: 3342–3346.

    Article  CAS  PubMed  Google Scholar 

  43. Cheung YH, Watkinson J, Anastassiou D . Conditional meta-analysis stratifying on detailed HLA genotypes identifies a novel type 1 diabetes locus around TCF19 in the MHC. Hum Genet 2011; 129: 161–176.

    Article  PubMed  Google Scholar 

  44. Cifuentes RA, Rojas-Villarraga A, Anaya J-M . Human leukocyte antigen class II and type 1 diabetes in Latin America: a combined meta-analysis of association and family-based studies. Hum Immunol 2011; 72: 581–586.

    Article  CAS  PubMed  Google Scholar 

  45. Rojas-Villarraga A, Botello-Corzo D, Anaya J-M . HLA-Class II in Latin American patients with type 1 diabetes. Autoimmun Rev 2010; 9: 666–673.

    Article  PubMed  Google Scholar 

  46. Alves C, Meyer I, Vieira N, Toralles MBP, LeMaire D . [Distribution and frequency of HLA alleles and haplotypes in Brazilians with type 1 diabetes mellitus]. Arq Bras Endocrinol Metabol 2006; 50: 436–444.

    Article  PubMed  Google Scholar 

  47. Brandao LC, Vatta S, Guimaraes R, Segat L, Araujo J, De Lima Filho JL et al. Rapid genetic screening for major human leukocyte antigen risk haplotypes in patients with type 1 diabetes from Northeastern Brazil. Hum Immunol 2010; 71: 277–280.

    Article  CAS  PubMed  Google Scholar 

  48. Hviid TVF, Christiansen OB . Linkage disequilibrium between human leukocyte antigen (HLA) class II and HLA-G —possible implications for human reproduction and autoimmune disease. Hum Immunol 2005; 66: 688–699.

    Article  CAS  PubMed  Google Scholar 

  49. Eike MC, Humphreys K, Becker T, Olsson M, Lie BA . Three microsatellites from the T1DGC MHC data set show highly significant association with type 1 diabetes, independent of the HLA-DRB1, -DQA1 and -DQB1 genes. Diabetes Obes Metab 2009; 11: 17–24.

    Article  CAS  PubMed  Google Scholar 

  50. Komulainen J, Kulmala P, Savola K, Lounamaa R, Ilonen J, Reijonen H et al. Clinical, autoimmune, and genetic characteristics of very young children with type 1 diabetes. Diabetes Care 1999; 22: 1950–1955.

    Article  CAS  PubMed  Google Scholar 

  51. Hathout EH, Hartwick N, Fagoaga OR, Colacino AR, Racine M, Nelsen-cannarella S et al. Clinical, autoimmune, and HLA characteristics of children diagnosed with type 1 diabetes before 5 years of age. Pediatrics 2003; 111: 860–863.

    Article  PubMed  Google Scholar 

  52. Dang MN, Mary Q . Epigenetics in autoimmune diseases with focus on type 1 diabetes. Diabetes Metab Res Rev 2013; 29: 8–18.

    Article  CAS  PubMed  Google Scholar 

  53. Varney MD, Valdes AM, Carlson JA, Noble JA, Tait BD, Bonella P et al. HLA DPA1, DPB1 alleles and haplotypes contribute to the risk associated with type 1 diabetes. Diabetes 2010; 59: 2055–2062.

    Article  CAS  PubMed  Google Scholar 

  54. Borchers A, Uibo R, Gershwin M . The geoepidemiology of type 1 diabetes. Autoimmun Rev 2010; 9: A355–A365.

    Article  PubMed  Google Scholar 

  55. Silveira A, Gomes M, Gomes J, Rosa A, Regina S, Neumann J et al. HLA-A, -B, and -DRB1 allelic and haplotypic diversity in a sample of bone marrow volunteer donors from Rio Grande do Sul State, Brazil. Hum Immunol 2012; 73: 180–185.

    Article  PubMed  Google Scholar 

  56. Trajanoski D, Fidler SJ . HLA typing using bead-based methods. Methods Mol Biol 2012; 882: 47–65.

    Article  CAS  PubMed  Google Scholar 

  57. Haldane J . The estimation and significance of the logarithm of a ratio of frequencies. Ann Hum Genet 1956; 20: 309–311.

    Article  CAS  PubMed  Google Scholar 

  58. Excoffier L, Lischer HEL . Arlequin suite ver 3.5: a new series of programs to perform population genetics analyses under Linux and Windows. Mol Ecol Resour 2010; 10: 564–567.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by CNPq research project (Grant number 620099/2008-9) and CAPES scholarship. We thank all of the volunteers who participated in this study. We are grateful for the technical support provided by students and technicians from LABMULT/UFRN/RN, LABIOMOL/UFRN/RN and FUNDHERP/SP in special to Neifi Hassan Saloum Deghaide. We also thank all of the physicians, nurses and hospital staff at HOSPED/UFRN who were involved in this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A A Rezende.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silva, H., Ururahy, M., Souza, K. et al. The association between the HLA-G 14-bp insertion/deletion polymorphism and type 1 diabetes. Genes Immun 17, 13–18 (2016). https://doi.org/10.1038/gene.2015.45

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/gene.2015.45

This article is cited by

Search

Quick links