Type 1 diabetes: recent developments
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7442.750 (Published 25 March 2004) Cite this as: BMJ 2004;328:750Data supplement
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Figure A Younger age of introduction of gluten (top) and cereal (bottom) greatly increases development of anti-islet autoantibodies in infants followed from birth. The top figure represents 65 islet autoantibody positive infants detected from a total of 1143 infants screened, and the bottom figure represents 34 islet autoantibody positive infants from a total of 1183 infants screened. Adapted from Norris et al12 and Ziegler et al13 (Available in: Eisenbarth GS, ed. Type 1A diabetes: cellular, molecular and clinical immunology, teaching slides www.barbaradaviscenter.org)
Figure B Progression to diabetes versus number of autoantibodies (GAD, ICA512(IA-2), insulin). Modified from Verge et al23 (Available in: Eisenbarth GS, ed. Type 1A diabetes: cellular, molecular and clinical immunology, teaching slides www.barbaradaviscenter.org)
Assays measuring diabetes associated autoantibodies in type 1 diabetes
AutoantibodySensitivity (%)Specificity (%)CommentInsulin autoantibody95-9849-80Higher levels in young childrenGAD (glutamic acid decarboxylase) autoantibody90-9584Higher sensitivity in adult onset type 1A diabetesICA512/IA-2 autoantibody90-9574Tyrosine phosphatase-like moleculeT cell assays demonstrated to detect major autoantigens in type 1 diabetes, with associated references
AntigenNOD mouse assays*Human assays†CommentInsulin, insulin peptideProliferation w20 w23ELISPOT w20MHC tetramer w21 w25Proliferationw17
ELISPOT w18No tetramers currently available to study in humansGlutamic acid decarboxylase (GAD), GAD peptideProliferation w21 w24 w25ELISPOT w21MHC tetramer w22 w23Proliferation w17ELISPOT w19MHC tetramer w26Adequate detection requires initial in vitro culturingIslet specific glucose-6-phosphatase (IGRP)MHC tetramer w21NoneNew autoantigen recently discoveredELISPOT=enzyme linked immunospot assay.
*T cell studies in mice from spleen or pancreas.
†T cell studies in humans from peripheral blood.
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