METHODS FOR IDENTIFYING ALLELES ASSOCIATED WITH INCREASED RISK OF DIABETES

Abstract: Methods for identifying individuals at increased risk of diabetes. The methods utilize the discovery of the DQw3.2 variant, which identifies a specific allelic polymorphism at a single gene locus. One preferred method utilizes a labeled probe to detect the DQw3.2 allele. This method involves estimating the size of the hybridizable DNA fragment generated by a specific restriction endonuclease and therefrom determining the presence of the allele. A second preferred method involves the serologic detection of the DQw3.2 allele. Within this method, immunocomplexes formed between two different MAb's and separate portions of a cell collection are detected and the presence or absence of the allele determined.

Description: Description METHODS FOR IDENTIFYING ALLELES ASSOCIATED WTTH INCREASED RISK OF DIABETES Technical Field The present invention relates generally to the disease known as insulin-dependent diabetes mellitus, and more specifically, to methods for identifying individuals at increased risk of diabetes. Background Art Diabetes mellitus is a complex syndrome (or syndromes) characterized by hyperglycemia , thicKening of basement membrane of the capillaries, and a variety of late complications, including accelerated atherosclerosis, retinopathy, neph ' ropathy , and neuropathy. (Parker, Clinical Immunology, V.II, 1980) . Diabetes may include any or all of the above syndromes, and affects approximately 2% of the U.S. population. Approximately i in 4 of these cases is insulin-dependent, referred to as IDDM, usually present in individuals below the age of 30, with tne rapid onset of glucose intolerance. While it is generally accepted that hereditary factors are important in the etiology of diabetes, the exact genetic mechanisms involved are not understood. The search for a genetic marker for susceptibility to diabetes had been unfruitful until 1973-74 when investigators first called attention to the relationship between diabetes and the major histocompatibility complex in man, called HLA. The HLA antigens are encoded by four loci on chromosome six, designated A, B, C and D. Most associ¬ ations between HLA and disease susceptibility have involved the D region of HLA. This locus was originally defined as the genetic region mismatch at which caused stimulation m a one-way mixed lymphocyte reaction (MLR) . Human τ a anti- gens map to the HLA-D region. These appear to be encoded by at least three distinct loci, DR, DQ and DP, each with its distinct alpha and beta chains. Each HLA-DR alloantigenic specificity (DRl-wl4) represents a serologically defined reaction pattern between well-characterized antisera and major histocompatibility complex (MHO class IT molecules. Accordingly, each speci¬ ficity corresponds to a particular epitope recognized by an alloant iserum which is present on HLA-D-encoded cell surface molecules. Among the HLA specificities, HLA-DR4 is the most interesting. This antigen has been found to occur more frequently in patients with adult rheumatoid arthritis, insulin-dependent diabetes, and some forms of juvenile rheumatoid arthritis than in the general population. However, analysis of the relationship between HLA-DR • • specificities and individual- class IT molecules expressed on homozygous typing cells has shown that structurally distinct molecules may be serologically indistinguishable. The implication of this finding is that what DR4 + cells have in common is the DR4 epitope carried by at least one of their D-region gene' products which reacts with tne DR4 alloant iserum to give a positive typing reaction. Beyond this cross-reactive epitope, however, each cluster of cells possesses a unique collection of class II antigens, such that "DR4" encompasses multiple distinct haplotypes. If specific haplotypes account for HLA associations with disease, then the serologic H A specificity alone is not a sufficiently specific marker to optimally predict disease risk. Restriction endonuclease digestion of genomic DNA may be used to identify specific nucleotide sequences, the presence or absence of which can function as markers for individual genes or gene segments. Fragments which nybrid- ize to a single probe can sometimes be assigned to specific genes. When such a fragment is variably expressed in different individuals, it is referred to as "polymorphic" and can potentially relate to functional differences. Investigators have previously reported a large number of restriction endonuclease fragment polymorphisms (RFLP) which exhibit some correlation with diabetes, hybrid¬ izing to DQB probes. (Cohen-Haguenauer et al . , PNAS 82: 3335-3339, 1985; Owerbach et al.. Nature 303: 815-817, 1983.) Despite these advances in understanding the genetic mechanisms involved in susceptibility to diabetes, the disease is currently diagnosed on the basis of clinical » presentation and laboratory tests. Clinical presentation can range from the obvious to the bewildering, depending on which symptoms appear first. Laboratory tests consisting of measurements of glucose and insulin and its precursors in the blood of patients, before ana after challenge of the patient with glucose itself , are diagnostic. Heretofore, noticeably absent from the art nas been the clinical ability to identify individuals who are at increased risk of diabetes prior to the onset of symptoms. The ability to identify individuals at increased risk of diabetes could have several important applications. It could be used within families of individuals witn known diabetes in order to predict whicr. other family members are at ris . Second, it could be used with individuals who exhibit diabetic symptoms in the context of other, more complex diseases, in an attempt to identify whether the individual has "traditional" diabetes which may be treated conventionally. Finally, should the identification of a risk factor for TDDM have sufficient predictive value, it can be anticipated that clinicians would use it within a screening test to identify individuals at increased risk for the disease. The present invention provides methods satisfying this need in the art for iden ifying indi iduals at increased risk of diabetes, and further provides other related advantages. Disclosure of the Invention Briefly stated, the present invention discloses methods for identifying individuals at increased risk of diabetes. One aspect of the invention essentially involves the steps of (a) incubating a first monoclonal antibody (MAb) reactive with DQw3.2 and DQw3.1 with a portion of a cell collection; (b) incubating a second monoclonal anti¬ body reactive with DQw3.1 with a separate portion of the cell collection; (c) detecting the presence of immuno- complexes formed between the first MAb and the cells, and the second MAb and the cells; and (d) determining from the results of the step of detection whether haplotypes associ¬ ated with, susceptibility to diabetes, such as the DQw3.2 haplotype, are present. The first and second monoclonal antibodies may be labeled, suitable labels including enzymes, f luorophores , radioisotopes, and luminescers. Tn a preferred embodiment of this method, the first MAb is P100.1 and the second MAb is A10 or GS 159.2, positive reactivity with PiOO.l and negative reactivity with A10 or GS 159.2 indicating the presence of a haplotype associated with susceptibility to diabetes. A second aspect of the present invention involves the steps of (a) incubating a first monoclonal antibody (MAb) reactive with DQw3.2 and DQw3.1 with a portion of a cell collection; (b) incubating a second monoclonal anti¬ body reactive with DQw3.2 with a separate portion of the cell collection; (c) detecting the presence of immuno¬ complexes formed between the first MAb and the cells, and the second MAb and the cells; and (d) determining from the results of the step of detection whether haplotypes associated with susceptibility to diabetes, such as the DQw3.2 haplotype, are present. In a preferred embodiment of this method, the first MAb is PiOO.l and the second MAb is GS 200.1, positive reactivity with both P100.1 and GS 200.1 indicating the presence of a haplotype associated with susceptibility to diabetes. A third aspect of the present invention involves a method for detecting the presence of a specific allele correlated with an increased risk of diabetes. The method comprises: (a) digesting DNA purified from a cell collec- tion with a restriction endonuclease to generate DNA frag¬ ments; (b) separating the DNA fragments on the basis of size; (c) hybridizing the separated fragments with a labeled probe substantially homologous with the DQB gene of HLA; and (d) detecting the signal from the hybridized probe, and therefrom determining the presence or absence of the allele. In a preferred embodiment of this method, the probe is comprised of the sequence GGAGCCCACAGTGACCATC. Other aspects of the invention will become evident upon reference to the following detailed description and attached drawings. Brief Description of the Drawings Figure 1 is a schematic illustrating the genomic location from which the probes of the present invention were derived. Figure 2 illustrates the structural difference between DQw3.1 and DQw3.2 at DQB 2 . Figure 3 depicts the hybridization pattern of restriction fragments generated from the DNA of diabetic and nondiabetic individuals. Best Mode for Carrying Out the Invention Witnin the present invention, applicants have found that there are multiple distinct DQ alleles within DR4 + haplotypes, and that specific haplotypes, rather than the serologic marker, identify disease susceptibility. One of the DQB genes, referred to as "DQBi," is relatively nonpolymorphic among individuals with similar DQ serologic typing specificities. The other DQB locus, referred to as "DQB2 , " is polymorphic among individuals who are serologically indistinguishable using conventional typing sera. Two stable DQB2 allelic variants exist which encode polypeptides carrying DQw3 specificities. These two DQB2 allelic variants differ from each other throughout a large portion of their genomic DNA, as evaluated by restric¬ tion mapping using a synthetic oligonucleot ide probe specific for the B2 exon. Upon analysis of 17 unrelated HLA DR4 + IDDM patients for genomic DQB polymorphisms, 16 exhibited a characteristic RFLP pattern for one of these specific DQB2 allelic variants, and not the other. This variant , referred to as n DQw3.2," therefore serves as a specific genomic marker for DQB2 genes on haplotypes carrying the DR4 serologic specificity, which are associated with IDDM. This specific variant includes some RFLP, such as a DQB 12.0 kb Bam HI and 1.9 kb Taq I fragments which were observed by other investigators in patients with diabetes, as noted above. Through the mapping of such nucleotide variation to a specif ic ' region of an expressed DQB gene, applicants have strongly implicated this gene product or a closely lirn ed product in disease susceptibility. The DQw3.2 variant identifies a specific allelic polymorphism at a single gene locus. The present invention, through the discovery of the DQw3.2 variant, provides two basic methods of identify- ing individuals at increased risk of diabetes. The first of these etnods involves the use of a labeled probe to detect the DQw3.2 allele. The second of these methods involves the serologic detection of the DQw3.2 allele. A. use of a Labeled Probe in the Diagnosis of DQw3.2 As noted above, the two DQB2 allelic variants differ from each other throughout a large portion of their genomic DNA. Six different restriction endonucleases, including Bam HT , Pvu TI, Hind TIT, Xba I, Taq I, and Sst I are all capable of recognizing this allelic difference within the method of the present invention. After purification of DNA from an individual of interest, digestion with one of the restriction endo- nucleases noted above may be performed. Following diges¬ tion, samples are electrophoresed on agarose gels in Tris acetate EDTA buffer. Subsequent to electrophoresis, the gels are dried on a vacuum gel dryer and the dried gels inserted in a polyethylene bag in the presence of radio- labeled probe DNA. Alternatively, Southern blot procedures may be used in which the gels are blotted onto nitrocel- lulose or nylon derivatized membranes. Such membranes may then optionally be UV- irradiated, and may be pre-hybridized with solutions containing nonradioactive RNA or DNA, before hybridization with labeled probe DNA. The sequence of the oligonucleotide probes used within the present invention is shown in Figure 1. As shown in Figure 1, preferred sequences include (a) GG AGCCC C AGTG ACC ATC ; and (b) GGAGCCCACAGTGACCATCTCCCCATCCAGGACAGAGGCCCTCAAC. The probe can be labeled with a radioisotope or an enzyme. Suitable radioisotopes include 32p , 3jj or 35e; Where the label is an enzyme, the enzyme can be conjugated directly to the probe, or indirectly via an avidin-biotin • bridge (Singer & Ward, PNAS 79: 7331; Pengolizzi et al . , in Advances in Gene Technology: Human Genetic Disorders, ed. F. Ahmad). Hybridization is detected by adding the appro- priate substrate ( s ) , cofactor(s) and/or chromogen(s) for the enzyme. After the probe DNA is synthesized, it can be labeled with, for instance, P32. In this exchange reaction, an P32 is provided at the 5' terminus of the oligonucleotide. The labeled oligonucleotide is diluted appropriately and incubated with the dried gel in the polyethylene bag under conditions which favor hybridization. After a sufficient length of time, the dried gel is removed, washed and subsequently exposed to x-ray film to reveal by autoradiography the presence of hybridizing bands. The size of the hybridizing fragments is then estimated relative to molecular weight standards. Referring now to Figure 2, it can be seen that the presence of the DQw3.2 allele can be distinguished from the presence of the DQw3.1 allele by the appearance of a 3.2 kb band and the absence of a 3.4 kb band when the purified DNA is digested with Hind Til. Alternati ely, when using the restriction endonuclease Bam HT , DQw3.2 can be distinguished from DQw3.1 by the appearance of a 12.0 Kb band and the absence of ' 6.9 kb and 3.7 kb bands. Comparable differences may be identified when using the other restriction endonucleases described above, as follows: DQw3.1 DQw3.2 Pvu IT - 3.55 kb 3.45 kb Xba I - 5.7 kb 2.35 kb Taq I - 4.55 kb 1.9 kb Sst I - 2.4 kb 2.2 kb B. Serologic Detection of the DQw3.2 Allele Within a preferred embodiment of this method of the present invention, four monoclonal antibodies, desig¬ nated P100.1, A10 , GS 159.2 and GS 200.1, may be used to identify the DQw3.2 allele. Antibodies P100.1, GS 159.2 and G^ 200.1 are monoclonal antibodies raised by fusion of mouse spleen cells immunized with human lymphoblastoid cell lines, with the myeloma NS-1, to yield hybridomas secreting monoclonal antibody. Antibody PiOO.l is directed against an epitope associated with the HLA-DQw3 specificity. Anti¬ body GS 159.2 detects an epitope associated with DQw3.1, while antibody GS 200.1 detects an epitope associated with DQw3.2. Antibody PiOO.l forms a part of the basis for pend¬ ing U.S. Patent Application Serial No. 740,124, attorney docket no. 9197-3-1, filed May 30, 1985, the text of which is herein incorporated by reference, and has been deposited with the ATCC under Accession No. HB-8822. Antibody GS 159.2 has been deposited with tne ATCC under Accession No. HB-9113. Antibody GS 200.1 has been deposited with the ATCC under Accession No. HB-9111. Antibody AIO is a monoclonal murine antibody available from Dr. Hiroo Maeda, Tokyo Blood Transfusion Service, Tokyo, Japan. The use an characterization of this antibody in screening HLA-type populations has been described (Bodmer et al . , Histo compability Testing 1984, eds. Albert, Baur and May (Springer-Verlag , Berlin) pp. 217-236; Maeda, H., Tissu Antigens 23: 163-170, 1984) . The antibodies described above may be used i cytotoxicity assays, and also in binding assays, includin but not limited to, ELTSA, micro-ELTSA, as identified i pending U.S. Patent Application Serial No. 740,124, attor¬ ney docket no. 9197-3-1, and fluorescence and radioimmun assays. Within any of these formats, cells from an indivi¬ dual or a patient are mixed with the antibodies separately, followed by the detection procedure (whether isotope, fluorescence, chromogen, or complement) and then analyzed for reactivity. Positive reactivity with PiOO.l and negative reactivity with A10 constitute the identification and diagnosis of the DQw3.2 allele. Alternatively, positive reactivity with PiOO.l and negative reactivity with GS 159.2 constitute the identification and diagnosis of the DQw3.2. al lele . Within the present invention, antibody GS 159.2 may be readily substituted for antibody A10 , and vice versa. Reactivity with P100.1, and A10 or GS 159.2, constitutes diagnosis of the DQw3.1 allele. Nonreactivity with PiOO.l, and A10 or GS 159.2, constitutes exclusion of both DQw3.1 and 3.2 alleles. Alternatively, the antibodies may be coated onto separate portions of a surface, such as plastic or filter paper, and the surface reacted with cells from an indivi¬ dual of interest. The surface is washed to remove unbound cells, and the bound cells then visualized by staining either with a protein stain, such as coomassie blue, or with a second, labeled antibody. To summarize the examples which follow, Example T demonstrates the use of a labeled probe in the diagnosis of DQw3.2. Example II demonstrates the serologic detection of the DQw3.2 allele. The following examples are offered by way of illustration and not by way of limitation. EXAMPLES EXAMPLE I USE OF A LABELED PROBE IN THE DIAGNOSIS OF DQW3.2 Homozygous Cell Lines (HCL) : EBV-transf ormed B lymphoblastoid cell lines were prepared from HLA-D homo¬ zygous donors to yield homozygous cell lines (HCL) , as described in detail by Nepom et al . (PNAS 80: 6962-6966, 1980) . Eighteen DR4-positive , three DR5-posi t i ve , one DRwl2-posit ive, two DR8-positive, one DR9-positive, and one DR7-positive HCL were used, and are listed in Table 1. Each of these HCL was also HLA-DQw3 positive. Digestion of Ge ' nomic DNA: Restriction endo¬ nuclease digestion of cellular DNA was performed at 37°C with two or more units of Bam HI or Hind III (Bethesda Research Laboratories) per ug of DNA for 18 hours. Digestion was monitored for completeness by minigel analy¬ sis of both the genomic digest and of lambda DNA to which an aliquot of the genomic digestion mixture had been added. Reactions were stopped by addition of EDTA to a final concentration of lOmM. DNA digests were concentrated by addition of 2/3 ' volume of 5 M ammonium acetate and 2 volumes of ethanol. After chilling 30 minutes in a dry ice methanol bath the DNA was pelleted in a microfuge for 8 min. Pellets were resuspended in TE (10 mM Tris-HCL ImM EDTA) . Southern Blotting: Restriction endonuclease- digested DNA (12 ug/lane) was applied to 0.7% agarose gels in Tris-acetate-EDTA buffer. La dba DNA digested with Hind TTT , and 0X 174 DNA digested with Hae HI (Bethesda Research Laboratories) were included as molecular weight markers. Gels were run at 1.5 volts per centimeter for 17 hours, then stained with ethidium bromide. The gels were soaked 15 min in 0.25 N HCl, followed by treatment with 0.5 N NaOH, 1.5 M NaCl for 1 hour to denature the DNA. Gels were neutralized by soaking 1 hour in 0.5 M Tris, 3.0 M NaCl , pH 7.0. The gels were then dried on a vacuum gel dryer at 65°C. The dried gel was then inserted into a polyethylene bag in the presence of a radiolabeled DNA probe. Synthesis and Labeling of an Oligonucleotide Probe: A DNA probe was synthesized as DQ46 on an Applied Biosystems instrument according to the manufacturer's speci¬ fications. DQ46 was labeled with P32 using the polynucle- otide kinase labeling procedure described in Maniatis, et al. (Molecular Cloning: A laboratory manual. Cold Spring Laboratory, 1982). In this exchange reaction, an P32 is provided ' at the 5' termininus of the oligonucleotide. Hybridization : 3 x 10^ to 5 x 10^ cpms of labeled oligonucleotide were diluted into 15-20 mis of 6X SSC and incubated with the dried gel in its polyethylene bag for 48 hours at 42°C. The dried gel was then removed, washed 3 times at room temperature in 2X ^ C, 0.1% SDS for 5 minutes per wash, and 2 times at 62°C in 2X SSC, 0.1% SDS for 20 minutes per wash. The dried gel was then exposed to x-ray film to reveal by autoradiography the presence of hybridizing bands (Figure 3). As shown in Figures 2 and 3, using the restric¬ tion endonuclease Hind ITT, the presence of a 3.2 Kb band in the absence of a 3.4 kb band is sufficient for the diagnosis of DQw3.2. EXAMPLE TI SEROLOGIC DETECTION OF THE DQw3.2 ALLELE There are three general kinds of assays used to type human lymphocytes for HLA antigen expression. First, and the one most used at the present time, is complement- dependent lysis. Second are assays measuring binding of antibody to lymphocytes by enzyme-linked im unoassay (FLT^A) . Elements of the first method have been combined with standard format ELISA assays to develop a micro-ELIS assay suitable for HLA typing. The third uses a fluoresc ing compound to measure binding of- antibody to lymphocytes. The micro-ELISA method will be described i detail, and the other methods in brief, as illustrations o the use of these methods. Micro-Enzyme-Linked Immunoabsorbent Assay (ELISA) to Detec Monoclonal Antibody Binding to HLA Antigens Determinin DQw3.2 Terasaki microtrays were prepared by addition t each well of 5 ul of a 1 ug/ml solution of poly-L-lysine i phosphate-buffered saline (PBS). The plates were incubate at 37°C for 1 hour and washed with PBS by immersion an decanting. Human leukocytes were dispensed into each well 1 ul of a suspension of 1 to 5 x 10^ cells per ml of RPMI 1640 medium without serum. The plates were centrifuged a 90 xg for 3 minutes. A solution of 1% bovine serum albumi (BSA) in PBS with 0.2% azide was added to the plates, whic were stored at 4°C for 1 to 48 hours. Before addin antibody, the plates were washed three times. In the indirect assay, monoclonal antibodies an controls were added to separate wells, 1 ul per well. After 1 hour at room temperature, the plates were wasned five times and a solution of the F(ab' )2 fragment of anti-immunoglobulin coupled with horseradish peroxidase (HRP) was added, 5 ul per well. The plates were then incubated at room temperature for 30 to 60 minutes. In the direct assay, HRP was coupled to the monoclonal antibody; the second step is thus unnecessary. Antibodies coupled to HRP were diluted in a solution of 0.1% B ς in PBS without azide. After treatment with antibody, the trays were wasned five times. The presence of HRP-antibody complexes in the wells was visualized by the addition of a solution of substrate (hydrogen peroxide) and chromogen (OPD, Organon Diagnostics, West Orange, NJ) or ABTS (Boehringer- Mannheim Biochemicals, Indianapolis, IN) in 0.1 M sodium citrate/0.2 M sodium phosphate. Color change in wells after 30 to 60 minutes incubation at room temperature indicated binding of monoclonal antibody to leukocytes in those wells. Reactivity with P100.1 and no reactivity with A10 detects and defines the DQw3.2 allele. Alternatively, reactivity with P100.1 and reactivity with GS 200.1 detects and defines the DQw3.2 allele. Detection of the DQw3.2 Specificity Using Monoclonal Anti¬ bodies Labeled with Fluorescein Isothiocyanate (FITC) Using a Fluorescence-Activated Cell Sorter (FACS) Monoclonal antibody isolated from ascites was conjugated to FTTC according to the method of Goding (Goding, J. Immunol. Methods 13: 215, 1976) . Cells to be analyzed were mixed with saturating amounts of FITC- conjugated antibody and incubated for 30 minutes at 4°C. Treated cells were washed and the amount of antibody bound assessed by comparing the fluorescence intensity (mean modal) of cells incubated with test and control antibodies on a FACS IV (Bectcn-Dickinson) f itted with a log amplifier . Detection of the DQw3.2 Specificity Using a Complement- Mediated Microcytotoxicity Assay In the direct assay, human leukocytes, 10^-10^, were dispensed into each well of a Terasaki microtray; 1 ul monoclonal antibodies and controls were added and incubated for 1 hour. Heterologous (rabbit or guinea pig) complement was then added. After incubation for 1 hour, the propor¬ tion of cells killed by the combination of specific anti¬ body and complement was determined by eosin dye uptake and read visually through a microscope. Alternati ely, the proportion of cells killed may be determined radiome r ical- ly or photometrically by release of bound ligand. Lysis of < 50% of cells is evidence of positive reactivity. In the indirect assay, leukocytes and antibodies are added as described above for the direct assay. Heterologous anti¬ body to murine immunoglobulin is added before addition of complement. The proportion of cells Killed is determined as described above for the direct assay. Reactivity of P100.1 but not AlO or GS 159.2 is evidence of the presence of DQw3.2. Alternatively, reactivity of P100.1 and GS 200.1 is also evidence of the presence of DQw3.2. Table 1 and Table 2 illustrate the results of DQw3.2 determinations in a population of homozygous typing cells and in a diabetic (TDDM) population. TABLE 1 Genomic and serologic polymorphic variants among HLA-DQw3 cell lines homozygous for HLA-D Monoclonal Antibody RFLP Reactivity Bam HT Hind TTI HCL HLA-D HLA- -DR HLA-DQ P100. ,1 A-10-83 ; GS 200 .1 12kb 6.9/3. 7 kb 3.4 kb or GS 159. 2 ER Dw4 DR4, ,w53 DQw3 + + .___. + + WALK* Dw4 DR4, ,w53 DQw3 + + + + + + NTN Dw4 DR4 ( ,w53 DQw3 + + - - . + -- PRTESS Dw4 DR4, ,w53 DQw3 + - + + - - MJ-4 Dw4 DR4, ,w53 DQw3 + - + + - - FM DwlO DR4, ,w53 DQw3 + - + + - - FS DwlO DR4 (f w53 DQw3 + - + + - - JHa Dwl3 DR4, ,w53 DQw3 + + - - + + ST Dwl3 DR4 (f w53 DQw3 + - + + — - THO Dwl4 DR4, ,w53 DQw3 + - + + - - BTN-40 Dwl4 DR4, ,w53 DQw3 + - + + — - LS-40 Dwl4 DR4, f w53 DQw3 + - + + — — KT-2 LD"K 2" DR4 ,w53 DQw3 + - + + — - KT-13 LD"KT2" DR4 ,w53 DQw3 + - + + — — TAS LD"T S" DR4 ,w53 DQw3 + - + + — - SWETG Dw5 DR5 ( ,w52 DQw3 + + — — + + JGL Dw5 DR5 ,w52 DQw3 + + — — + f JME Dw5 DR5 ( ,w52 DQw3 + + — — + + FLF DB6 DRwl2,w52 DQw3 + + — — +• f 8854 Dw8 DRw8,w52 DQw3 + + — — + + LUY Dw8 DRw8 ,w52 DQw3 + + _ — f Kf)Z l)R r ) ORw9 , 53 now3 + — h — _ JK ϋwll DR7, ,w53 DQw3 + ^ + + — — *WALK, although homozygous for HLA-D , is heterozygous for the DQw3.1 and DQw3. 2 alleles . TABLE 2 Increase of DQw3.2 among HLA-DR4 diabetics compared to nondiabetics DQw3.1 DQw3.2 DR4 diabetics 1/17 (6%) 16/17 (94%) DR4 nondiabetics 10/26 (38%) 16/26 (62%) From the foregoing, it will be appreciated that, although specific embodiments of the invention have been described herein 'for purposes of illustration, various modifications may be made without deviating from the spirit and scope of -the invention. Accordingly, the invention is not to be limited except as by the appended claims.

Claims: Claims 1. A method for identifying haplotypes associated with susceptibility to diabetes within a cell collection, comprising: incubating a first monoclonal antibody reactive with DQw3.1 and DQw3.2 with a portion of said cell collection; incubating a second monoclonal antibody react iye with DQw3.1 with a separate portion of said cell collection; detecting the presence of immunocomplexes formed between said first monoclonal antibody and said cells, and said second monoclonal antibody and said cells; and determining from the results of the step of detection whether the DQw3.2 haplotype is present. 2. The method of claim 1 wherein said first mono¬ clonal antibody is PiOO.l. 3. The method of claim 1 wherein said second monoclonal antibody is AlO or GS 159.2. 4. The method of claim 1 wherein said first and second monoclonal antibodies are labeled. 5. The method of claim 1 wherein the. step of detecting is by enzyme reaction, fluorescence or luminescence emission or cell lysis. 6. The method of claim 1 wherein said first antibody is PiOO.l and said second antibody is AlO or GS 159.2. 7. A method for identifying haplotypes associated with susceptibility to diabetes within a cell collection, comprising: incubating a first monoclonal antibody reactive with DQw3.1 and DQw3.2 with a portion of said cell collection; incubating a second monoclonal antibody reactive with DQw3.2 with a separate portion of said cell collection; detecting the presence of immunocomplexes formed between said first monoclonal antibody and said cells, and said second monoclonal antibody and said cells; and determining from the results of the step of detection whether the DQw3.2 haplotype is present. 8. The method of claim 7 wherein said first mono¬ clonal antibody is PiOO.l. 9. The method of claim 7 wherein said second mono¬ clonal antibody is GS 200.1. 10. The method of claim 7 wherein said first and second monoclonal antibodies are labeled. 11. .The method of claim 7 wherein the step of detection is by enzyme reaction, fluorescence or luminescence emission, or cell lysis. 12. The method of claim 7 wherein said first antibody is P100.1 and said second antibody is GS 200.1. 13. A method for detecting the presence of a specific allele correlated with an increased risk of diabetes, comprising: digesting DNA purified from a cell collection with a restriction endonuclease to generate DNA fragments; separating said DNA fragments on the basis of size; hybridizing said separated fragments with a labeled probe substantially homologous with the DQB gene of the HLA; and detecting the signal from said hybridized probe, and therefrom determining the presence of said allele. 14. The method of claim 13 wherein the probe is comprised of the. sequence GGAGCCCACAGTGACCATC. 15. The method of claim 13 wherein the probe is comprised of the sequence GGAGCCCACAGTGACCATCTCCCCATCCAGGACAGA- GGCCCTCAAC . 16. The method of claim 13 wherein said restriction endonuclease is selected from the group consisting of Bam HI, Pvu II, Hind III, Xba T, Taq I, and Sst I. 17. The method of claim 13 wherein the restriction endonuclease is Hind ITT, and the presence of said allele is identified by the appearance of a 3.2 kb hybridizable fragment and the absence of a 3.4 kb fragment. 18. A method for .identifying haplotypes associated with susceptibility- to diabetes within a cell collection, comprising: coating a portion of a surface with a f irst monoclonal antibody reactive with DQw3.1 and DQw3.2; coating a separate portion of said surface with a second monoclonal antibody reactive with DQw3.1; reacting said cell collection with both portions of said surface; and detecting the presence of cells bound to said portions of the surface and therefrom determining the presence or absence of said haplotypes. 19. A monoclonal antibody produced by cell line HB-8822. 20. A monoclonal antibody produced by cell line HB-9113. 21. A monoclonal antibody produced by cell line HB-9111. 22. A diagnostic composition for identifying haplotypes associated with susceptibility to diabetes within a cell col lect i on compr i si ng th e DNA sequen ce GGAGCCCAC GTG CCATC . 23. A diagnostic composition for identifying haplotypes associated with susceptibility to diabetes within a cel l col lect ion compri si ng the DNA sequence GGAGCCCACAGTG ACCATCTCCCCATCCAGGACAGAGGCCCTCAAC. 24. A diagnostic composition for identifying haplotypes associated with susceptibility to diabetes within a cell collection comprising a monoclonal antibody according to any of claims 19, 20, or 21.

Inventors: NELSON KAREN A, NEPOM BARBARA S, NEPOM GERALD T, NELSON, KAREN, A., NEPOM, BARBARA, S., NEPOM, GERALD, T.
Applicants: GENETIC SYSTEMS CORP, GENETIC SYSTEMS CORPORATION
Application year: 1986
Main classification: G01N33
IPC codes: C07K14, C07K16, C07K19, C12N15, C12P21, C12Q1, G01N33