Evidence map›Paper›PMID 41758964›Full record

ArticleDiabetes2026

Biallelic Pathogenic Variants in IL2RA Cause Neonatal-Onset Monogenic Autoimmune Diabetes.

Georgia Bonfield, James Russ-Silsby, Suraj Ramchand, Amber M Luckett, Matthew N Wakeling, Abhishek Kulkarni, V Sri Nagesh, Asma Deeb, K G Ravikumar, Phuong T K Nguyen and 6 more

Abstract read
In one paragraph

Article in Diabetes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

16 authors.

Georgia BonfieldClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
James Russ-SilsbyClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Suraj RamchandClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Amber M LuckettClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Matthew N WakelingClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Abhishek KulkarniSRCC Children's Hospital, Mumbai, India.
V Sri NageshSri Nagesh Endocrine Centre, Hyderabad, India.
Asma DeebSheikh Shakhbout Medical City & Khalifa University, Abu Dhabi, United Arab Emirates.
K G RavikumarKanchi Kamakoti CHILDS Trust Hospital, Chennai, India.
Phuong T K NguyenDa Nang Hospital for Women and Children, Da Nang, Vietnam.
Andrew T HattersleyClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Richard A OramClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Sarah E FlanaganClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Elisa De FrancoClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.
Matthew B JohnsonClinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.ORCID 0000-0002-6519-6687
EXE-T1D Consortium*

Funding

Breakthrough T1D 23/0006516Diabetes UK 19/005971Diabetes UK 23/0006516European Foundation for the Study of Diabetes NNF23SA0087432Leona M. and Harry B. Helmsley Charitable Trust 2016PG-T1D049Leona M. and Harry B. Helmsley Charitable Trust 2018PG-T1D049Leona M. and Harry B. Helmsley Charitable Trust 2103-05059Leona M. and Harry B. Helmsley Charitable Trust G-2404-06858NIHR Exeter Clinical Research FacilityNovo Nordisk Foundation Center for Basic Metabolic Research NNF23SA0087432Randox Laboratories LtdWellcome Trust 223187/Z/21/Z
6 · The paper itself

Abstract

Autoimmune diabetes presenting in infancy or with additional autoimmune disorders can be the result of highly penetrant variants in key immune homeostasis genes. An example of this is observed with biallelic pathogenic variants in IL2RA (CD25), which causes immunodeficiency 41 (IMD41). IL2RA encodes the α-chain of the interleukin-2 receptor, which helps regulate the growth and activity of T cells. The diabetes phenotype in IMD41 has not been systematically described. We sequenced IL2RA in 290 individuals with diabetes diagnosed <6 months and in 64 individuals diagnosed <10 years who had additional autoimmunity. We also reviewed all previously reported IMD41 cases. We identified five new unrelated individuals with biallelic pathogenic IL2RA variants. Four presented with diabetes in the first month of life with very low/absent C-peptide, and all were GAD antibody-positive. Of 17 previously reported cases, 9 had diabetes, yielding a total of 14 of 22 (64%) with early-onset diabetes. No relationship between variant location/type and diabetes development was observed. Autoimmune diabetes is therefore a common and early feature of IMD41. IL2RA should be included in genetic testing panels for neonatal and monogenic autoimmune diabetes. These findings highlight the important role of IL2RA in immune tolerance and β-cell protection. ARTICLE HIGHLIGHTS: We report five new cases of neonatal or early childhood-onset diabetes caused by biallelic pathogenic variants in IL2RA. Autoimmune diabetes was the presenting feature in most individuals and occurs in 64% of all reported cases of immunodeficiency 41. Patients typically presented in infancy with diabetic ketoacidosis, low C-peptide, and GAD antibody positivity, highlighting an autoimmune etiology. The diabetes phenotype was consistent across cases but not linked to variant type or location. IL2RA should be included in genetic testing for neonatal diabetes and considered in children with diabetes plus immune dysregulation.

Indexed as

Diabetes Mellitus, Type 1Interleukin-2 Receptor alpha SubunitAllelesChildChild, PreschoolC-PeptideFemaleHumansInfantInfant, NewbornMaleMutationC-PeptideIL2RA protein, humanInterleukin-2 Receptor alpha Subunit

Identifiers

PMID41758964
PMCPMC13097203

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.