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pubmed-article:16966600pubmed:abstractTextType 1A diabetes (T1D) is an autoimmune disorder the risk of which is increased by specific HLA DR/DQ alleles [e.g., DRB1*03-DQB1*0201 (DR3) or DRB1*04-DQB1*0302 (DR4)]. The genotype associated with the highest risk for T1D is the DR3/4-DQ8 (DQ8 is DQA1*0301, DQB1*0302) heterozygous genotype. We determined HLA-DR and -DQ genotypes at birth and analyzed DR3/4-DQ8 siblings of patients with T1D for identical-by-descent HLA haplotype sharing (the number of haplotypes inherited in common between siblings). The children were clinically followed with prospective measurement of anti-islet autoimmunity and for progression to T1D. Risk for islet autoimmunity dramatically increased in DR3/4-DQ8 siblings who shared both HLA haplotypes with their diabetic proband sibling (63% by age 7, and 85% by age 15) compared with siblings who did not share both HLA haplotypes with their diabetic proband sibling (20% by age 15, P < 0.01). 55% sharing both HLA haplotypes developed diabetes by age 12 versus 5% sharing zero or one haplotype (P = 0.03). Despite sharing both HLA haplotypes with their proband, siblings without the HLA DR3/4-DQ8 genotype had only a 25% risk for T1D by age 12. The risk for T1D in the DR3/4-DQ8 siblings sharing both HLA haplotypes with their proband is remarkable for a complex genetic disorder and provides evidence that T1D is inherited with HLA-DR/DQ alleles and additional MHC-linked genes both determining major risk. A subset of siblings at extremely high risk for T1D can now be identified at birth for trials to prevent islet autoimmunity.lld:pubmed
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pubmed-article:16966600pubmed:authorpubmed-author:ErlichHenry...lld:pubmed
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pubmed-article:16966600pubmed:authorpubmed-author:YuLipingLlld:pubmed
pubmed-article:16966600pubmed:authorpubmed-author:MiaoDongmeiDlld:pubmed
pubmed-article:16966600pubmed:authorpubmed-author:FainPamela...lld:pubmed
pubmed-article:16966600pubmed:authorpubmed-author:IdeAkaneAlld:pubmed
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pubmed-article:16966600pubmed:authorpubmed-author:BarrigaKather...lld:pubmed
pubmed-article:16966600pubmed:authorpubmed-author:BarkerJennife...lld:pubmed
pubmed-article:16966600pubmed:authorpubmed-author:AlyTheresa...lld:pubmed
pubmed-article:16966600pubmed:authorpubmed-author:JahromiMohame...lld:pubmed
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pubmed-article:16966600pubmed:dateRevised2009-11-18lld:pubmed
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pubmed-article:16966600pubmed:year2006lld:pubmed
pubmed-article:16966600pubmed:articleTitleExtreme genetic risk for type 1A diabetes.lld:pubmed
pubmed-article:16966600pubmed:affiliationBarbara Davis Center for Childhood Diabetes and Human Medical Genetics Program, University Colorado Health Sciences Center, Aurora, CO 80045, USA.lld:pubmed
pubmed-article:16966600pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:16966600pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed
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