| Screening for insulinoma antigen 2 and zinc transporter 8 autoantibodies: a cost-effective and age-independent strategy to identify rapid progressors to clinical onset among relatives of type 1 diabetic patients. | |
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MedLine Citation:
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PMID: 23199327 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In first-degree relatives of type 1 diabetic patients, we investigated whether diabetes risk assessment solely based on insulinoma antigen 2 (IA-2) and zinc transporter 8 (ZnT8) antibody status (IA-2A, respectively, ZnT8A) is as effective as screening for three or four autoantibodies [antibodies against insulin (IAA), glutamate decarboxylase 65 kDa (GAD) glutamate decarboxylase autoantibodies (GADA) and IA-2A with or without ZnT8A] in identifying children, adolescents and adults who progress rapidly to diabetes (within 5 years). Antibodies were determined by radiobinding assays during follow-up of 6444 siblings and offspring aged 0-39 years at inclusion and recruited consecutively by the Belgian Diabetes Registry. We identified 394 persistently IAA(+) , GADA(+) , IA-2A(+) and/or ZnT8A(+) relatives (6·1%). After a median follow-up time of 52 months, 132 relatives developed type 1 diabetes. In each age category tested (0-9, 10-19 and 20-39 years) progression to diabetes was significantly quicker in the presence of IA-2A and/or ZnT8A than in their joint absence (P < 0·001). Progression rate was age-independent in IA-2A(+) and/or ZnT8A(+) relatives but decreased with age if only GADA and/or IAA were present (P = 0·008). In the age group mainly considered for immune interventions until now (10-39 years), screening for IA-2A and ZnT8A alone identified 78% of the rapid progressors (versus 75% if positive for ≥ 2 antibodies among IAA, GADA, IA-2A and ZnT8A or versus 62% without testing for ZnT8A). Screening for IA-2A and ZnT8A alone allows identification of the majority of rapidly progressing prediabetic siblings and offspring regardless of age and is more cost-effective to select participants for intervention trials than conventional screening. |
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Authors:
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F K Gorus; E V Balti; I Vermeulen; S Demeester; A Van Dalem; O Costa; H Dorchy; S Tenoutasse; T Mouraux; C De Block; P Gillard; K Decochez; J M Wenzlau; J C Hutton; D G Pipeleers; I Weets; |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical and experimental immunology Volume: 171 ISSN: 1365-2249 ISO Abbreviation: Clin. Exp. Immunol. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2012-12-03 Completed Date: 2013-02-19 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0057202 Medline TA: Clin Exp Immunol Country: England |
Other Details:
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Languages: eng Pagination: 82-90 Citation Subset: IM |
Copyright Information:
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© 2012 British Society for Immunology. |
Affiliation:
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Diabetes Research Center, Brussels Free University, Brussels, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Autoantibodies / blood*, economics Belgium Blood Glucose / immunology Cation Transport Proteins / immunology* Child Child, Preschool Diabetes Mellitus, Type 1 / blood, immunology* Disease Progression* Family Female Glutamate Decarboxylase / immunology Humans Insulin / immunology Male Prediabetic State / blood*, immunology Receptor-Like Protein Tyrosine Phosphatases, Class 8 / immunology* Registries Risk |
| Grant Support | |
ID/Acronym/Agency:
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P30-DK-57516/DK/NIDDK NIH HHS; R01 DK052068/DK/NIDDK NIH HHS; R01-DK-052068/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Autoantibodies; 0/Blood Glucose; 0/Cation Transport Proteins; 0/Insulin; 0/SLC30A8 protein, human; EC 3.1.3.48/PTPRN protein, human; EC 3.1.3.48/Receptor-Like Protein Tyrosine Phosphatases, Class 8; EC 4.1.1.15/Glutamate Decarboxylase; EC 4.1.1.15/glutamate decarboxylase 2 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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