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Comparative analysis of epitope recognition of glutamic acid decarboxylase (GAD) by autoantibodies from different autoimmune disorders

Autoantibodies to GAD, an important marker of the autoimmune process in type I or insulin‐dependent diabetes mellitus (IDDM), are also found in non‐diabetic individuals with autoimmune polyendocrine syndrome type 1 (APS1), APS2, and stiff man syndrome (SMS). Most IDDM sera contain two distinct GAD antibody specificities, one of which targets an epitope region in the middle‐third of GAD65 (IDDM‐E1; amino acids 221–359) and one of which targets the carboxy‐third of GAD65 (IDDM‐E2; amino acids 453–569). Using 11 chimeric GAD65/GAD67 proteins to maintain conformation‐dependent epitopes of GAD65, we compared the humoral repertoire of IgG antibodies from an individual with APS2‐like disease (b35, b78, and b96) and MoAbs from an IDDM patient (MICA‐2, MICA‐3, and MICA‐4). Neither the APS2 IgG antibodies nor the IDDM MoAbs bind the amino‐terminal third of GAD65, but instead target the carboxy‐terminal two‐thirds of GAD65. Amino acids 270–359 (IDDM‐E1) are targeted by one APS2 IgG antibody and MICA‐4, while two other APS2 IgG antibodies, MICA‐2 and MICA‐3, target amino acids 443–585 (IDDM‐E2). Using GAD65/67 chimera that span the IDDM‐E2 region, we found that MICA‐2 binds amino acids 514–528 of GAD65, but two APS2 IgG antibodies require this region and amino acids 529–570. In contrast, the binding of MICA‐3 requires two discontinuous amino acid segments of GAD65 (452–513 and 528–569), but not amino acids 514–528. These results indicate that there are both similarities and differences in the humoral response to GAD65 in APS2 and IDDM.