Relation between the major histocompatibility (B) locus and autoimmune thyroiditis in obese chickens

Molecular mimicry and clonal deletion: A fresh look

In this article, I trace the historic background of clonal deletion and molecular mimicry, two major pillars underlying our present understanding of autoimmunity and autoimmune disease. Clonal deletion originated as a critical element of the clonal selection theory of antibody formation in order to explain tolerance of self. If we did have complete clonal deletion, there would be major voids, the infamous "black holes", in our immune repertoire. For comprehensive, protective adaptive immunity, full deletion is necessarily a rare event. Molecular mimicry, the sharing of epitopes among self and non-self antigens, is extraordinary common and provides the evidence that complete deletion of self-reactive clones is rare. If molecular mimicry were not common, protective adaptive immunity could not be all-encompassing. By taking a fresh look at these two processes together we can envision their evolutionary basis and understand the need for regulatory devices to prevent molecular mimicry from progressing to autoimmune disease.

The genetics of autoimmune thyroiditis: the first decade

Most of our current understanding of the genetic predisposition to autoimmune disease can be traced to experiments performed in the decade from 1971 to 1981. Chella David was a key contributor to this research. Many of these early steps came from studies of experimental autoimmune thyroiditis. This model has been especially valuable because essentially the same disease can occur spontaneously in selected strains of animals or can be induced by deliberate immunization. From a genetic point of view, the disease has been investigated in three different species: mice, rats and chickens. The same antigen, thyroglobulin, initiates the disease in all three species. Among the main discoveries were the relationship of autoimmune disease to the major histocompatibility complex (MHC), the interplay of different subregions within the MHC in promoting or retarding development of disease, the differing roles of MHC class II and MHC I class genes in induction and effector phases, respectively, and the cumulative effect of non-MHC genes, each of which represents a small addition to overall susceptibility. Other experiments revealed that genetic differences in thyroglobulin allotypes influence susceptibility to thyroiditis. Thyroid glands differed in different strains in vulnerability to passive transfer of antibody. The first evidence of modulatory genes on the sex-related X chromosome emerged. All of these genetic findings were concurrently translated to the human disease, Hashimoto's thyroiditis, where thyroglobulin is also the initiating antigen.

Navigating the passage between Charybdis and Scylla: recognizing the achievements of Noel Rose

This special edition of the Journal of Autoimmunity is dedicated to celebrate the enormous contributions of Dr. Noel Rose, a physician-scientist, someone that can be readily anointed as a gifted scientist who laid down the foundation and fundamental concepts of human autoimmunity. Dr. Rose performed a series of landmark studies that extend back more than 50 years and whose work is the cornerstone of the commonly used term "from the bench to the bedside." The studies included not only characterization of a normal immune response but, more importantly, defining the nature of not only the antigen, but also the aberrant response that results in organ, tissue specific reactions and immunopathology. These pioneering studies contributed to the biochemical nature of antigens, dissection of the immune repertoire, the recognition of the importance of genetics and environment, and the distinctions between a normal and an autoimmune response. Hence, this volume has been coined "Navigating the Passage Between Charybdis and Scylla: Recognizing the Achievements of Noel Rose."

Lymphocyte antigens in sheep

This paper describes the detection of 13 lymphocyte antigens in sheep. The results obtained from family studies are consistent with the hypothesis that at least 12 antigens are under the control of a single genetic system. The distribution of antigens in the population suggests that the system contains two loci. The 13 antigens were compared with those previously reported. Only one additional specificity was found.

Life amidst the contrivances

The established dogma of 'horror autotoxicus' was overturned 50 years ago with the publication of a paper showing that autoimmune thyroiditis could be induced in animals. Noel Rose recounts the events that led to the establishment of autoimmunity as a cause of disease.

Avian models with spontaneous autoimmune diseases

Autoimmune diseases in human patients only become clinically manifest when the disease process has developed to a stage where functional compensation by the afflicted organ or system is not possible anymore. In order to understand the initial etiologic and pathogenic events that are generally not yet accessible in humans, appropriate animal models are required. In this respect, spontaneously developing models--albeit rare--reflect the situation in humans much more closely than experimentally induced models, including knockout and transgenic mice. The present chapter describes three spontaneous chicken models for human autoimmune diseases, the Obese strain (OS) with a Hashimoto-like autoimmune thyroiditis, the University of California at Davis lines 200 and 206 (UCD-200 and -206) with a scleroderma-like disease, and the amelanotic Smyth line with a vitiligo-like syndrome (SLV). Special emphasis is given to the new opportunities to unravel the genetic basis of these diseases in view of the recently completed sequencing of the chicken genome.

Avian models of autoimmune disease: lessons from the birds

Many important lessons have been learned from studies of autoimmune diseases in chicken models. It is now quite clear that both cellular and humoral immune responses are important in developing the final picture of autoimmune disease. In the case of the amelanosis of Smyth line (SL) chickens, antibody appears to play the primary role, whereas the sclerosis of University of California/Davis line-200 (UCD-200) birds is mainly mediated by T cells. Chronic thyroiditis of the OS chicken is due to both humoral and cellular effector mechanisms. The Obese strain (OS) chicken is particularly valuable for studies of genetics. Multiple genetic factors converge in producing maximal susceptibility to the development of autoimmune thyroiditis. They include MHC genes responsible for immune recognition; genes affecting thymus development, critical for regulation of the immune response; and genes that control thyroid function, influencing the vulnerability of the target organ to autoimmune attack. The importance of environmental factors, such as dietary iodine, is also strongly supported by studies in the OS chicken. Thus, the birds have provided valuable clues to our understanding of human autoimmune disorders in the past and are expected to do so in the future.

B haplotype influence on the relative efficacy of Marek's disease vaccines in commercial chickens

The objectives were to investigate whether or not B haplotypes influence vaccinal immunity against Marek's disease (MD) in commercial chickens and to evaluate whether retrospective analysis would detect the influence. This method involved evaluating the B haplotypes of turkey herpesvirus (HVT)-vaccinated sick vs normal chickens from a flock afflicted with MD symptoms. An analysis of the retrospective data disclosed that MD symptoms were present in a higher proportion of B2B19 than B2B21 chickens. A prospective study was then conducted with blood-typed chickens of the strain vaccinated with HVT or HVT + 301B bivalent MD vaccines prior to inoculation of the very virulent Md5 virus. The bivalent vaccine provided better protection than HVT alone, but with either vaccine fewer B2B21 chickens developed MD lesions. We conclude that the B haplotype influence on vaccinal immunity against MD previously demonstrated in B-congenic strains of chickens is also significant in commercial chickens and that the influence can be detected through analysis of B haplotypes in sick vs normal chickens of an affected flock.

Identification of class II major histocompatibility complex polymorphisms predicted to be important in peptide antigen presentation

Chickens of the B2, B5, B15, B19, and B21 B-congenic haplotypes differ in disease resistance. Complementary DNA from B-congenic chicken strains have been analyzed for allelic diversity of expressed Class II MHC genes. The predicted amino acid sequences of eight genes from five haplotypes were subjected to Wu-Kabat variability analysis. The B-L gene polymorphic regions and conserved regions are highly similar to the human leukocyte antigen Class II genes. Therefore, the present analysis reveals candidate polymorphisms important in determining the spectrum of antigenic peptides presented to T helper cells, and allelic differences possibly important in resistance to avian disease.

Genetic control of immunity to Eimeria tenella. Interaction of MHC genes and non-MHC linked genes influences levels of disease susceptibility in chickens

The relative importance of MHC genes and background genes in the genetic control of disease susceptibility and the development of protective immunity to E. tenella infection was investigated in eight different strains of 15I5-B congenic and four inbred chicken strains. RPRL 15I5-B congenic chickens that share a common genetic background but express different B haplotypes demonstrated wide variations in disease susceptibility and the development of acquired resistance to E. tenella infection. Infection of chickens sharing a common B haplotype but expressing different genetic backgrounds showed quite contrasting levels of susceptibility to secondary E. tenella infection. In all chicken strains examined, infected chickens developed high levels of serum and biliary anti-coccidial antibodies regardless of their B haplotypes. Furthermore, no correlation between antibody levels and the phenotypically expressed levels of disease resistance was demonstrated. These findings lend support to the view that interaction of MHC genes and non-MHC genes influences the outcome of host response to E. tenella infection.

Eimeria acervulina: evaluation of the cellular and antibody responses to the recombinant coccidial antigens in B-congenic chickens

The roles of major histocompatibility complex (MHC) and non-MHC-linked genes in the genetic control of disease susceptibility and the development of protective immunity to Eimeria acervulina infection were investigated in six 15I5-B congenic and four different strains of chickens characterized for the MHC. When oocyst production was assessed, wide variations were noted following initial and challenge infections among the strains of chickens tested. In general, 15.N-21, 15.P-13, B21, B19, SC, and FP chickens were protected following challenge infection whereas 15I5, 15.P-19, 15.7-2, and 15.6-2 chickens were not. Strains of chickens sharing a same B haplotype on different genetic backgrounds did not show comparable levels of protection. These results lead to the view that non-MHC-linked genes have a profound influence on the outcome of the host response to E. acervulina infection. Chickens infected twice at 1-month intervals by an oral inoculation with E. acervulina developed both coccidial-specific antibody and T-cell responses. E. acervulina infected chickens showed T-cell-mediated immune responses to the intact sporozoites as well as to recombinant proteins, p130 of sporozoites and p150 of merozoites. Both p130 and p150 antigens have been identified and characterized previously. Sera obtained from all infected chickens recognized the p150 merozoite protein, but not the p130 sporozoite protein in immunoblots. In general, the cellular response, but not the antibody response to the p150 recombinant surface merozoite antigen correlated with the degree of protection following the challenge infection. These results suggest that the strains of chickens having improved protection against challenge infection demonstrate higher T-cell responses to the recombinant surface merozoite protein, p150.

Quantitative differences in Ia antigen expression in the spleens of 15I5-B congenic and inbred chickens as defined by a new monoclonal antibody

A monoclonal antibody (MAb), designated P2M11, that detects a monomorphic determinant of chicken class II antigens was produced from the fusion of P3X63 myeloma cells with spleen cells from BALB/c mice immunized with chicken splenic lymphocytes. Flow cytometric analyses of lymphocytes from the SC and FP strains of chickens showed 30 to 50% staining of bursa cells, 15 to 20% staining cells, and less than 5% staining of thymus cells. Addition of MAb P2M11 to splenic of T cell cultures stimulated with allogeneic cells or concanavalin A resulted in a significant inhibition of the T cell proliferation responses. Immunoprecipitation of 35S-methionine-labeled spleen cell extracts using MAb P2M11 identified molecules with apparent molecular weights of approximately 28,000, 30,000, and 32,000 by sodium dodecyl-polyacryl-amide gel electrophoresis. Taken together, these data indicate that the antigens detected by MAb P2M11 are similar in cell distribution and structure to chicken Ia antigens encoded by B-L genes. Using this MAb, a strain difference was demonstrated in the tissue distribution of Ia antigen positive lymphocytes in the spleens but not the thymuses of 15I5-B congenic and inbred strains of chickens. This difference may be due to the genes associated with B-complex genes.

Hypothesis: immunogenetic analysis of spontaneous autoimmune thyroiditis in obese strain (OS) chickens: a two-gene family model

Analysis of the number of genes involved in the regulation of the expression of SAT in OS, by means of crosses with the unrelated inbred CB line, gave the following results: 1) The production of Tg-AAb is regulated by one or two genes; 2) the sensitivity of the thyroid to autoimmune attack is under the control of about 3 genes; 3) the expression of SAT, as measured by mononuclear cell infiltration of the thyroid gland, is thus encoded by at least 4-5 genes (approximately 2 of which regulate the immune system hyperreactivity against antigens of the thyroid, and 3 of which regulate the sensitivity of the target organ to an attack by the immune system. It should, however, not be forgotten that this calculation, which results in 5 genes as being crucial for the development of SAT, is only valid for the combination of the OS and the CB inbred line. A different number might have arisen with the use of a different inbred line for crossing experiments. 4) The genes involved in the genetic control of SAT can be divided into two categories, major and minor genes. One family of major genes regulates the hyperreactivity of the immune system and perhaps its specificity for thyroid antigens. A second family of major genes encodes the target organ susceptibility to the attack of the immune system. The minor genes modulate the expression of the major genes and are especially important in animals with an incomplete set of major genes. The influence of sex hormones and the MHC are examples of such genes. MHC genes play an important role in outbred populations, but they are not a prerequisite for the development of the disease. Fully developed, early onset SAT is only seen in an animal where all major genes are present. The existence of two-gene families, each composed of relatively few genes, might guarantee to a species that SAT will not be too frequent in outbred populations.

The multi-factorial pathogenesis of autoimmune disease

Development of organ-specific autoimmune diseases depends on both an abnormal immune regulation and a genetically determined primary susceptibility of the target organ to the autoimmune attack. In addition to the essential genetically determined prerequisites there are also facultative, modulating factors that influence the outcome of an autoimmune disease. This concept is exemplified in the Obese strain (OS) chicken model which develops a spontaneous autoimmune thyroiditis closely resembling human Hashimoto disease. Three modulating factors are specifically addressed, viz. (a) the lower threshold of OS thyroid epithelial cells for the gamma-interferon-induced MHC class II antigen expression as compared to normal controls, (b) the decreased glucocorticoid tonus of the OS and (c) the presence of a new endogenous virus (ev 22) locus in the OS that has so far not been found in any normal strain and which seems to influence the glucocorticoid-mediated immunoregulatory process.

Influence of the major histocompatibility complex on disease resistance and productivity

Publications in which chickens of different B haplotypes were studied for differences in disease resistance or productivity traits are reviewed. The most prominent effects on diseases are those involving tumors, but other examples involving autoimmune disease and microbial infections not resulting in neoplasia or autoimmunity are also cited. Each referenced disease paper is briefly defined with regard to: population used, B alleles present, and the most resistant B types. Studies citing B haplotype influences on productivity and reproductive fitness traits are summarized and the most desirable B genes in each referenced population are given. Plausible mechanisms of the B haplotype's influence on the traits are briefly discussed. Based on the evidence reviewed for disease resistance and productivity traits and the central role of B-complex genes in immune function, it is concluded that poultry breeders should develop B-genotype information in their base breeding populations and use those types yielding optimal performance.

The role of genetically-determined primary alterations of the target organ in the development of spontaneous autoimmune thyroiditis in obese strain (OS) chickens

Immunologists working in the field of autoimmunity tend to concentrate all their efforts on the elucidation of possible malfunctions of the immune system, particularly pathologic changes of immune regulation. Also in the OS model various groups of investigators emphasized this approach, although it was already clear early in the history of this model that SAT has a multigenic background. The fact that this disease cannot be transferred into normal, histocompatible animals without an appropriate non-MHC linked genetic background was a strong indication that detailed studies of thyroid-associated factors may be warranted for the elucidation of the pathogenesis of this disease and perhaps also its human counterpart, Hashimoto thyroiditis. Since several reviews on the immunologic aspects in the OS model have been published in recent years we have in this communication attempted to discuss the - mostly still rudimentary - findings concerning the target organ itself, including morphological changes before the beginning of infiltration, the analysis of Tg, the altered thyroid function before onset of SAT, the results of cross-breeding studies of OS and inbred normal chickens in respect to the susceptibility of the offspring for the transfer of SAT, the possible role of a virus infection and the aberrant expression of MHC class II antigens on TEC. Cross-breeding studies revealed that most probably a single gene is responsible for the primary altered thyroid function and at least 3 genes code for the susceptibility of the OS thyroid gland to the autoimmune attack. It is not yet clear for which of the above-mentioned observations each of these genes is responsible and what is/are the initial triggering mechanism(s). Ongoing studies in our laboratory concentrate on this question, specifically the potential role of endogenous viruses in this process.

Genetic aspects of antibody responses in chickens to different classes of antigens

Six breeding groups of chickens, each characterized by a different haplotype of the B blood group system, were challenged with different classes of antigens, namely Newcastle disease vaccine (ND), infectious bronchitis vaccine (IB), infectious bursal disease viral agent (IBD), Salmonella pullorum antigen (P), and sheep red blood cells (SRBC). Parents were challenged at 20 weeks of age, and their offspring were challenged at 3 weeks of age. Blood samples were taken from the parents at 1 week after challenge, and from the offspring at 1, 2, 3, and 4 weeks after challenge for determination of antibody titers to each antigen. The offspring were also challenged at 8 weeks of age in the wing-web with Rous sarcoma virus (RSV). Tumor scores were taken weekly on individual chickens for the next 10 weeks. There were significant differences (P less than .01) between breeding groups of parents for antibody titer responses to ND, IB, P, and SRBC. There were significant differences (P less than .05) between the breeding groups of offspring for antibody titer responses to ND, IB, IBD, P, and SRBC. There were significant (P less than .01) differences between the breeding groups in the accumulative tumor scores over the 10-week period. The lines that cause regression of Rous sarcomas (R-lines) were significantly (P less than .01) superior in resisting tumor growth to those lines that allow progressive growth of tumors (Pr-lines). The only antigen to which the R-lines gave significantly (P less than .01) higher titers of antibody responses than the Pr-lines was SRBC.

Genetically-controlled severity of autoimmune thyroiditis in Obese strains (OS) chickens is expressed at both the humoral and cellular effector mechanism levels

Two lines of Obese strain (OS) chickens of identical MHC (B) genotype, B5B5, bred over 10 years with different selection parameters, differ in their severity of spontaneous autoimmune thyroiditis. To determine whether alterations in immune responsiveness underly this discrepancy, the two lines were compared for their thyroiditis effector mechanisms. The OS B5B5 chickens, selected for high levels of serum thyroglobulin autoantibody, had correspondingly higher levels of thyroid-specific cytotoxic cells and also antibody dependent cellular cytotoxicity (ADCC) than the equivalent B5B5 line selected solely for the phenotypic trait of hypothyroidism. These results thus emphasize the importance of the non-MHC locus controlling immune responsiveness, in the 3 locus-model for this autoimmune disorder.

Regulation of experimental autoimmune thyroiditis: influence of non-H-2 genes

Experiments were conducted to investigate the non-H-2 genetic effects on experimental autoimmune thyroiditis (EAT). Strains having C3H or BALB background in general produced higher autoimmune responses to mouse thyroglobulin (MTg) than the B10 or A strains. Comparisons of C3H and B10 congenic strains carrying similar H-2 haplotypes demonstrated that the C3H congenics had significantly higher MTg antibody titres and more severe thyroid damage, even when the strains carry the low responder H-2 haplotypes. These observations show that non-H-2 gene(s) influences EAT, in addition to genes in the MHC.

Genetic influences on spontaneous autoimmune thyroiditis in (CS X OS)F2 chickens

Genetic effects on spontaneous autoimmune thyroiditis in chickens were assessed by measuring phenotypic symptoms, the titer of circulating antibody to thyroglobulin, and the pathological change in the thyroids of young chicks. One or more loci within the B complex (the major histocompatibility complex of the chicken) are responsible for the expression of autoimmunity, and evidence is provided for an interaction of the B haplotype with genes at other loci. The influence of the B complex component on genetic susceptibility is more visible in animals with limited susceptibility at other loci and becomes indistinguishable as the frequency of other genes determining thyroid autoimmunity increases.

Chicken major histocompatibility complex and disease

The chicken MHC (B complex) initially described by Briles as controlling blood antigens, is now known to be composed of at least three regions, L, F and G. Two of these, F and G, were described on the basis of recombinants found in a study of over 10,000 chickens. On the basis of biochemical, tissue distribution and functional analyses, F corresponds to the murine H-2 K/D regions. The G region is unique to the chicken since the antigenic product is expressed only on erythrocytes and their progenitors. L was identified by serological studies and corresponds to the H-2 I region; the L antigen is expressed predominantly on B lymphocytes, monocytes and 10% of T lymphocytes, and differences in the L region result in variations in immune responsiveness. A number of functional similarities exist between the chicken MHC and that of other species such as regulation of graft rejection, graft-versus-host reaction (GVHR) and mixed lymphocyte reactions (MLR), mitogenic and immune responsiveness and resistance to RNA and DNA virus infection. The chicken MHC also controls the severity of autoimmune disease, as exemplified by the spontaneous thyroiditis of Obese strain (OS) chickens. It differs from mammalian MHC's by having of lower crossing-over frequency and no apparent gene duplication.

The association of goitrous autoimmune thyroiditis with HLA-DR5

We found HLA-DR5 to be present among 53% of 40 patients with goitrous autoimmune (Hashimoto's ) thyroiditis compared to 26% of 80 controls. No deviations from those expected in the incidences of HLA-A, B, C antigens were seen. In contrast HLA-DR3 was increased among 50 patients with atrophic thyroiditis (65%) compared to controls (24%). These findings stress the immunogenetic heterogeneity between the goitrous and atrophic varieties of thyroiditis.

The association of HLA--B8 with atrophic thyroiditis

One-hundred-and-forty-seven patients with autoimmune thyroiditis were studied with respect to HLA antigens as they related to various clinical features. HLA--B8 was found to be significantly increased among 59 patients with atrophic thyroiditis (57% vs. 26% for controls) but was identical to controls in 88 patients with goitrous thyroiditis (26%). No relation was found in either group between B8 and thyroid autoantibody titer or, in the case of goitrous thyroiditis, the rate of progression of the disease. Thus a link seems to be established between Graves' disease and atrophic thyroiditis in that both are significantly associated with HLA-B8. This study stresses the need to take clinical features into consideration when examining for HLA/disease associations.

Role of B cells in the expression of genetic resistance to growth of Rous sarcoma in the chicken

Resistance to the development of progressively growing tumors induced by Rous sarcoma virus is a dominant trait controlled by a gene linked to the major histocompatibility complex (MHC). The effect of bursectomy (Bx) on the expression of this trait was studied in two inbred lines of chickens homozygous for different MHC alleles, and which differ with respect to the gene controlling resistance to Rous tumors. The results show that Bx alters the expression of the trait, since genetically resistant birds were rendered highly susceptible to progressive tumor growth. The bursa of Fabricius thus makes an important contribution to resistance. The results do not indicate whether genetic resistance is mediated exclusively by B cells or by another bursa-dependent population.

Fc receptor-bearing lymphoid cells in the chicken. II. Relative increase of Fc(IgG) receptor bearing cells in obese strain-chickens

An EA rosette technique is used to study ontological development and organ distribution of Fc(IgG) receptor-bearing lymphoid cells in normal CS White Leghorn chickens, and in OS chickens with spontaneous autoimmune thyroiditis. During the embryonic period, no difference was seen between CS and OS in the tissue distribution of cells with Fc receptors. At the time of hatching and subsequently, the OS chickens possessed relatively more Fc receptor-bearing lymphoid cells than did CS chickens. The increase of Fc receptor-bearing lymphoid cells was most prominent among spleen cells. No difference in the affinity of Fc receptors between lymphocytes of the OS and CS chickens was demonstrated. The possible role of Fc receptor-carrying cells in the development of autoimmune thyroiditis is discussed.

Marek's disease: effects of B histocompatibility alloalleles in resistant and susceptible chicken lines

Lines of chickens selected from a common ancestral population for either resistance or susceptibility to Marek's disease developed contrasting frequencies of particular B alloalleles. Comparison of inoculated sibs in backcross-families revealed that the B alloalleles characterizing the two lines accounted for an eightfold difference in tumor incidence. This genetic difference in tumorigenesis associated with the alloalleles of the major histocompatibility complex is probably expressed through the cell-mediated immune system.

Genetic and cellular control of spontaneous autoimmune thyroiditis in OS chickens

B-locus genotypes have been defined in Obese strain (OS) chickens that spontaneously develop autoimmune thyroiditis (SAT), and in White Leghorn Cornell C strain (CS) chickens from which the OS was selected. The B-locus influences SAT, and some possible mechanisms are discussed. Thymic abnormalities in OS, as contrasted with CB birds, are also discussed and may play a role in SAT, as may an intrinsic defect in the thyroid gland itself.

The association of HLA with autoimmune thyroid disease in Newfoundland. The influence of HLA homozygosity in Graves' disease

Forty-seven patients with Graves' disease, 73 with thyroiditis and 128 controls drawn from the same geographical area of Newfoundland were HLA typed. The frequency of HLA-B8 was significantly increased in the Graves' disease patients when compared to the control group giving a relative risk of 3.9. There were no significant HLA differences between the thyroiditis and control groups. Homozygosity for the HLA haplotype, which is common in this island population, was more common in Graves' disease patients (12.8%) than in controls (5.5%) but did not reach statistical significance in this sample. Homozygosity was due in five of the six cases to either an A1;B8 haplotype or an A2;B8 haplotype. This contrasted with an apparently random assortment of haplotypes in the control and thyroiditis groups. Calculations suggest that homozygosity for a B8 haplotype confers an additional risk over heterozygosity for B8 of about 3.5 fold; however, homozygosity had no observable influence on the severity of the disease. These results strengthen the idea that B8, or an allele in linkage disequilibrium with it, determines in part the susceptibility of an individual to developing Graves' disease.