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Quantitative assay using recombinant human islet glutamic acid decarboxylase (GAD65) shows that 64K autoantibody positivity at onset predicts diabetes type

Hagopian, William A. ; Karlsen, Allan E. LU ; Gottsäter, Anders LU ; Landin-Olsson, Mona LU ; Grubin, Catherine E. ; Sundkvist, Göran LU ; Petersen, Jacob S. ; Boel, Esper ; Dyrberg, Thomas and Lernmark, Åke LU orcid (1993) In Journal of Clinical Investigation 91(1). p.368-374
Abstract

At and before onset, most insulin-dependent diabetics (IDDM) have islet GAD65 autoantibodies (GAD65Ab). Since IDDM also occurs in older patients where non-insulin-dependent diabetes is common, we studied GAD65Ab at onset to classify diabetes type. Our quantitative immunoprecipitation assay uses recombinant human islet GAD65 stably expressed in hamster fibroblasts. Electrophoretic mobility was identical to native islet GAD65. Like native antigen, recombinant GAD65 migrated as two bands during electrophoresis, but converted to one under stronger reduction. Immunoprecipitation was linear with respect to antibody or antigen concentration. In 120 population-based diabetic patients of all ages grouped by treatment at onset and after 18 mo,... (More)

At and before onset, most insulin-dependent diabetics (IDDM) have islet GAD65 autoantibodies (GAD65Ab). Since IDDM also occurs in older patients where non-insulin-dependent diabetes is common, we studied GAD65Ab at onset to classify diabetes type. Our quantitative immunoprecipitation assay uses recombinant human islet GAD65 stably expressed in hamster fibroblasts. Electrophoretic mobility was identical to native islet GAD65. Like native antigen, recombinant GAD65 migrated as two bands during electrophoresis, but converted to one under stronger reduction. Immunoprecipitation was linear with respect to antibody or antigen concentration. In 120 population-based diabetic patients of all ages grouped by treatment at onset and after 18 mo, GAD65Ab were present in 70% on insulin (n = 37), 10% on oral agent (n = 62, P < 0.0001), 69% changing from oral agent to insulin (n = 16, P < 0.001), and 1 of 33 controls. 65% with GAD65Ab, versus 8% without, changed from oral agent to insulin (P < 0.01). The GAD65Ab quantitative index was remarkably stable, and only 2 of 32 patients changed antibody status during follow-up. Concordance between GAD65Ab and islet cell antibodies was 93%. Quantitative correlation was approximate but significant. This highly sensitive, quantitative, high capacity assay for GAD65Ab reveals treatment requirements better than clinical criteria, perhaps guiding immunomodulatory therapy.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Autoantigen, Autoimmunity, BHK fibroblasts, Immunoprecipitation, Islet cell antibodies
in
Journal of Clinical Investigation
volume
91
issue
1
pages
7 pages
publisher
The American Society for Clinical Investigation
external identifiers
  • pmid:8423232
  • scopus:0027391608
ISSN
0021-9738
DOI
10.1172/JCI116195
language
English
LU publication?
yes
id
e0557944-da3a-4f5f-b30d-2335cd7efaab
date added to LUP
2019-09-11 09:27:47
date last changed
2024-04-02 15:46:39
@article{e0557944-da3a-4f5f-b30d-2335cd7efaab,
  abstract     = {{<p>At and before onset, most insulin-dependent diabetics (IDDM) have islet GAD65 autoantibodies (GAD65Ab). Since IDDM also occurs in older patients where non-insulin-dependent diabetes is common, we studied GAD65Ab at onset to classify diabetes type. Our quantitative immunoprecipitation assay uses recombinant human islet GAD65 stably expressed in hamster fibroblasts. Electrophoretic mobility was identical to native islet GAD65. Like native antigen, recombinant GAD65 migrated as two bands during electrophoresis, but converted to one under stronger reduction. Immunoprecipitation was linear with respect to antibody or antigen concentration. In 120 population-based diabetic patients of all ages grouped by treatment at onset and after 18 mo, GAD65Ab were present in 70% on insulin (n = 37), 10% on oral agent (n = 62, P &lt; 0.0001), 69% changing from oral agent to insulin (n = 16, P &lt; 0.001), and 1 of 33 controls. 65% with GAD65Ab, versus 8% without, changed from oral agent to insulin (P &lt; 0.01). The GAD65Ab quantitative index was remarkably stable, and only 2 of 32 patients changed antibody status during follow-up. Concordance between GAD65Ab and islet cell antibodies was 93%. Quantitative correlation was approximate but significant. This highly sensitive, quantitative, high capacity assay for GAD65Ab reveals treatment requirements better than clinical criteria, perhaps guiding immunomodulatory therapy.</p>}},
  author       = {{Hagopian, William A. and Karlsen, Allan E. and Gottsäter, Anders and Landin-Olsson, Mona and Grubin, Catherine E. and Sundkvist, Göran and Petersen, Jacob S. and Boel, Esper and Dyrberg, Thomas and Lernmark, Åke}},
  issn         = {{0021-9738}},
  keywords     = {{Autoantigen; Autoimmunity; BHK fibroblasts; Immunoprecipitation; Islet cell antibodies}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{368--374}},
  publisher    = {{The American Society for Clinical Investigation}},
  series       = {{Journal of Clinical Investigation}},
  title        = {{Quantitative assay using recombinant human islet glutamic acid decarboxylase (GAD65) shows that 64K autoantibody positivity at onset predicts diabetes type}},
  url          = {{http://dx.doi.org/10.1172/JCI116195}},
  doi          = {{10.1172/JCI116195}},
  volume       = {{91}},
  year         = {{1993}},
}