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Plasma GAD65, a Marker for Early beta-Cell Loss After Intraportal Islet Cell Transplantation in Diabetic Patients

Ling, Zhidong; De Pauw, Pieter; Jacobs-Tulleneers-Thevissen, Daniel; Mao, Rui; Gillard, Pieter; Hampe, Christiane S.; Martens, Geert A.; Veld, Peter In't; Lernmark, Åke LU and Keymeulen, Bart, et al. (2015) In Journal of Clinical Endocrinology and Metabolism 100(6). p.2314-2321
Abstract
Context and Objective: Intraportal islet transplantation can restore insulin production in type 1 diabetes patients, but its effect is subject to several interfering processes. To assess the influence of beta-cell loss before and during engraftment, we searched for a real-time marker of beta-cell destruction. Previous studies showed that 65-kDa isoform of glutamate decarboxylase (GAD65) is discharged by chemically damaged rat beta-cells. We therefore examined the utility of the GAD65 assay to detect and quantify destruction of human beta-cells in vitro and in vivo. Design and Participants: A time-resolved fluorescence immunoassay was used to measure GAD65 discharge from beta-cells after administration of toxins or after intraportal... (More)
Context and Objective: Intraportal islet transplantation can restore insulin production in type 1 diabetes patients, but its effect is subject to several interfering processes. To assess the influence of beta-cell loss before and during engraftment, we searched for a real-time marker of beta-cell destruction. Previous studies showed that 65-kDa isoform of glutamate decarboxylase (GAD65) is discharged by chemically damaged rat beta-cells. We therefore examined the utility of the GAD65 assay to detect and quantify destruction of human beta-cells in vitro and in vivo. Design and Participants: A time-resolved fluorescence immunoassay was used to measure GAD65 discharge from beta-cells after administration of toxins or after intraportal transplantation. The study in patients involved type 1 diabetes recipients of 56 implants. Results: GAD65 was discharged from cultured human beta-cells between 4 and 24 hours after acute insult and proportional to the number of dying cells. It was also detected in plasma during the first 24 hours after intraportal transplantation of human islet cell grafts. Diabetic nude rat recipients without hyperglycemic correction exhibited higher plasma GAD65 levels than those with normalization. In type 1 diabetes recipients of grafts with 2-5 x 10(6) beta-cells per kilogram of body weight, five of six with plasma GAD65 greater than 1 ng/mL failed to increase plasma C-peptide by greater than 0.5 ng/mL at posttransplant month 2, whereas five of six with undetectable plasma GAD 65 and 15 of 19 with intermediate levels did result in such increase. Conclusion: Plasma GAD65 qualifies as a marker for early beta-cell loss after intraportal transplantation. Further studies are needed to extend its clinical utility. (Less)
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Contribution to journal
publication status
published
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in
Journal of Clinical Endocrinology and Metabolism
volume
100
issue
6
pages
2314 - 2321
publisher
The Endocrine Society
external identifiers
  • wos:000360840000044
  • scopus:84930802160
ISSN
1945-7197
DOI
10.1210/jc.2015-1216
language
English
LU publication?
yes
id
161fe417-412e-4aa4-9ea9-afc2a63585e9 (old id 8077374)
date added to LUP
2015-11-19 10:37:44
date last changed
2017-10-22 04:18:27
@article{161fe417-412e-4aa4-9ea9-afc2a63585e9,
  abstract     = {Context and Objective: Intraportal islet transplantation can restore insulin production in type 1 diabetes patients, but its effect is subject to several interfering processes. To assess the influence of beta-cell loss before and during engraftment, we searched for a real-time marker of beta-cell destruction. Previous studies showed that 65-kDa isoform of glutamate decarboxylase (GAD65) is discharged by chemically damaged rat beta-cells. We therefore examined the utility of the GAD65 assay to detect and quantify destruction of human beta-cells in vitro and in vivo. Design and Participants: A time-resolved fluorescence immunoassay was used to measure GAD65 discharge from beta-cells after administration of toxins or after intraportal transplantation. The study in patients involved type 1 diabetes recipients of 56 implants. Results: GAD65 was discharged from cultured human beta-cells between 4 and 24 hours after acute insult and proportional to the number of dying cells. It was also detected in plasma during the first 24 hours after intraportal transplantation of human islet cell grafts. Diabetic nude rat recipients without hyperglycemic correction exhibited higher plasma GAD65 levels than those with normalization. In type 1 diabetes recipients of grafts with 2-5 x 10(6) beta-cells per kilogram of body weight, five of six with plasma GAD65 greater than 1 ng/mL failed to increase plasma C-peptide by greater than 0.5 ng/mL at posttransplant month 2, whereas five of six with undetectable plasma GAD 65 and 15 of 19 with intermediate levels did result in such increase. Conclusion: Plasma GAD65 qualifies as a marker for early beta-cell loss after intraportal transplantation. Further studies are needed to extend its clinical utility.},
  author       = {Ling, Zhidong and De Pauw, Pieter and Jacobs-Tulleneers-Thevissen, Daniel and Mao, Rui and Gillard, Pieter and Hampe, Christiane S. and Martens, Geert A. and Veld, Peter In't and Lernmark, Åke and Keymeulen, Bart and Gorus, Frans and Pipeleers, Daniel},
  issn         = {1945-7197},
  language     = {eng},
  number       = {6},
  pages        = {2314--2321},
  publisher    = {The Endocrine Society},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {Plasma GAD65, a Marker for Early beta-Cell Loss After Intraportal Islet Cell Transplantation in Diabetic Patients},
  url          = {http://dx.doi.org/10.1210/jc.2015-1216},
  volume       = {100},
  year         = {2015},
}