Role of insulin autoantibody affinity as a predictive marker for type 1 diabetes in young children with HLA-conferred disease susceptibility. Export

@article{citeulike:5938638, abstract = {BACKGROUND: Insulin autoantibodies (IAA) are early markers of prediabetic autoimmunity. As transient and fluctuating IAA positivity are common among young children, distinguishing non-progressive IAA from destruction-related IAA is essential when preventive measures are considered. We tested whether children progressing rapidly to type 1 diabetes (progressors) are characterized by a higher prediabetic IAA affinity than IAA-positive children remaining unaffected or progressing more slowly to diabetes (non-progressors), and whether IAA affinity increases towards diagnosis. METHODS: Finnish children with HLA-conferred diabetes susceptibility were observed from birth for diabetes-associated autoantibodies and progression to overt type 1 diabetes. IAA levels and affinities of the first IAA-positive prediabetic samples and samples obtained closest to the diagnosis in 64 progressors were compared with corresponding values in 64 matched IAA-positive non-progressors. RESULTS: The median age at diagnosis was 3.9 years in progressors and the median follow-up time 7.6 years among unaffected subjects. In the first samples the median IAA affinity was 1.4 x 10(10) L/mol in both groups (p = 0.33), while at the second sampling it was 1.1 x 10(10) L/mol in progressors and 1.2 x 10(10) L/mol in unaffected subjects (p = 0.46). No changes in affinity levels were observed (p = 0.33 and p = 0.84, respectively). IAA titers increased towards diagnosis among progressors (from a median of 13.6 to 20.1 relative units; p = 0.02). CONCLUSIONS: Among young IAA-positive children with HLA-conferred disease susceptibility IAA affinity failed to distinguish rapid progressors from slowly or non-progressing subjects. In relation to IAA affinity, no maturation of the humoral immune response was observed over time from seroconversion to diagnosis.}, author = {Siljander, Heli and H\"{a}rk\"{o}nen, Taina and Hermann, Robert and Simell, Satu and Hekkala, Anne and Salonsaari, Riikka-Tiina T. and Simell, Tuula and Simell, Olli and Ilonen, Jorma and Veijola, Riitta and Knip, Mikael}, citeulike-article-id = {5938638}, citeulike-linkout-0 = {http://dx.doi.org/10.1002/dmrr.998}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19637309}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19637309}, doi = {10.1002/dmrr.998}, issn = {1520-7560}, journal = {Diabetes/metabolism research and reviews}, month = {October}, number = {7}, pages = {615--622}, posted-at = {2009-10-14 09:58:14}, priority = {2}, title = {Role of insulin autoantibody affinity as a predictive marker for type 1 diabetes in young children with HLA-conferred disease susceptibility.}, url = {http://dx.doi.org/10.1002/dmrr.998}, volume = {25}, year = {2009} }

TY - JOUR ID - citeulike:5938638 L3 - citeulike-article-id:5938638 N2 - BACKGROUND: Insulin autoantibodies (IAA) are early markers of prediabetic autoimmunity. As transient and fluctuating IAA positivity are common among young children, distinguishing non-progressive IAA from destruction-related IAA is essential when preventive measures are considered. We tested whether children progressing rapidly to type 1 diabetes (progressors) are characterized by a higher prediabetic IAA affinity than IAA-positive children remaining unaffected or progressing more slowly to diabetes (non-progressors), and whether IAA affinity increases towards diagnosis. METHODS: Finnish children with HLA-conferred diabetes susceptibility were observed from birth for diabetes-associated autoantibodies and progression to overt type 1 diabetes. IAA levels and affinities of the first IAA-positive prediabetic samples and samples obtained closest to the diagnosis in 64 progressors were compared with corresponding values in 64 matched IAA-positive non-progressors. RESULTS: The median age at diagnosis was 3.9 years in progressors and the median follow-up time 7.6 years among unaffected subjects. In the first samples the median IAA affinity was 1.4 x 10(10) L/mol in both groups (p = 0.33), while at the second sampling it was 1.1 x 10(10) L/mol in progressors and 1.2 x 10(10) L/mol in unaffected subjects (p = 0.46). No changes in affinity levels were observed (p = 0.33 and p = 0.84, respectively). IAA titers increased towards diagnosis among progressors (from a median of 13.6 to 20.1 relative units; p = 0.02). CONCLUSIONS: Among young IAA-positive children with HLA-conferred disease susceptibility IAA affinity failed to distinguish rapid progressors from slowly or non-progressing subjects. In relation to IAA affinity, no maturation of the humoral immune response was observed over time from seroconversion to diagnosis. IS - 7 JF - Diabetes/metabolism research and reviews SN - 1520-7560 EP - 622 TI - Role of insulin autoantibody affinity as a predictive marker for type 1 diabetes in young children with HLA-conferred disease susceptibility. VL - 25 SP - 615 AU - Siljander, Heli AU - Härkönen, Taina AU - Hermann, Robert AU - Simell, Satu AU - Hekkala, Anne AU - Salonsaari, Riikka-Tiina AU - Simell, Tuula AU - Simell, Olli AU - Ilonen, Jorma AU - Veijola, Riitta AU - Knip, Mikael PY - 2009/10// UR - http://dx.doi.org/10.1002/dmrr.998 ER -