2021
DOI: 10.1007/s00125-021-05492-6
|View full text |Cite
|
Sign up to set email alerts
|

Improving clinical utility of GAD65 autoantibodies by electrochemiluminescence assay and clinical phenotype when identifying autoimmune adult-onset diabetes

Abstract: Aims/hypothesis It is important to differentiate the two major phenotypes of adult-onset diabetes, autoimmune type 1 diabetes and non-autoimmune type 2 diabetes, especially as type 1 diabetes presents in adulthood. Serum GAD65 autoantibodies (GADA) are the most sensitive biomarker for adult-onset autoimmune type 1 diabetes, but the clinical value of GADA by current standard radiobinding assays (RBA) remains questionable. The present study focused on the clinical utility of GADA differentiated by … Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
2
1

Citation Types

0
9
1

Year Published

2022
2022
2024
2024

Publication Types

Select...
6

Relationship

2
4

Authors

Journals

citations
Cited by 15 publications
(10 citation statements)
references
References 15 publications
0
9
1
Order By: Relevance
“…Despite these approaches, results will show false positive cases, that is cases which appear to have GADA, but actually are T2D, or false negative cases, that is cases which appear not to have GADA but actually are T1D [34]. The former is probably higher than the latter, but the percent is debateable and hence 'controversial' and likely false positive cases are represented by less than 25% of all GADA positive cases with apparently autoimmune non-insulin requiring diabetes instead having T2D [33]. On the other hand, the presence of more than one autoantibody likely reflects T1D and a high risk of early progression to insulin dependence [1,8,9].…”
Section: Autoantibodiesmentioning
confidence: 98%
See 1 more Smart Citation
“…Despite these approaches, results will show false positive cases, that is cases which appear to have GADA, but actually are T2D, or false negative cases, that is cases which appear not to have GADA but actually are T1D [34]. The former is probably higher than the latter, but the percent is debateable and hence 'controversial' and likely false positive cases are represented by less than 25% of all GADA positive cases with apparently autoimmune non-insulin requiring diabetes instead having T2D [33]. On the other hand, the presence of more than one autoantibody likely reflects T1D and a high risk of early progression to insulin dependence [1,8,9].…”
Section: Autoantibodiesmentioning
confidence: 98%
“…Autoantibodies lack specificity, though assays are more specific now than they were (specificity now 97.5% or higher compared with 95% previously) [32]. But, increasing specificity by altering the antigen or by using an electroluminescence assay comes at the cost of decreased sensitivity [32,33]. Despite these approaches, results will show false positive cases, that is cases which appear to have GADA, but actually are T2D, or false negative cases, that is cases which appear not to have GADA but actually are T1D [34].…”
Section: Autoantibodiesmentioning
confidence: 99%
“…Electrochemiluminescence (ECL), a technique with the advantages of high sensitivity, low background interference, convenient control, simple operation, and persistent luminescence, which combines the features of chemiluminescence and electrochemistry involving the process of light emission in the redox reaction, has been regarded as one of the most promising analytical techniques in the fields of biology, pharmacy, food safety, immunoassay, disease diagnosis, environmental monitoring, nucleic acid assay, , and clinical treatment . However, for the reason of the ECL luminescent reagents need to match the requirements of electro-excitation and chemiluminescence at the same time, there are few luminescent reagents that could be adopted for ECL practical application. , As a consequence, the ECL approach is restricted to the detection of complex systems containing multi-analytes.…”
Section: Introductionmentioning
confidence: 99%
“…In contrast, glycemia worsened significantly in subjects with a single IAb confirmed by ECL assay, comparable with the worsening in subjects with multiple IAbs; the latter group had a higher progression to T1D (30%). In an ongoing Autoimmunity Screening for Kids (ASK) study screening general population children in Colorado, USA, as high as 80% of single IAb positivity generated by RBA were found to be ECL negative with low-affinity IAbs ( 48 ). Remarkably, high affinity IAbs confirmed at a patient’s very first initial positive visit stayed high affinity consistently over time ( 49 ).…”
mentioning
confidence: 99%
“…There are approximately 30M individuals with T2D in the United States ( 50 ) and the number increases annually. For identifying T1D in adult-onset diabetes, both the standard RBA and the ELISA based assay were reported to be problematic for disease specificity ( 48 , 51 ), resulting in difficultly differentiating between true positives (T1D) and false positive (T2D). To correctly diagnose the type of diabetes, more disease specific IAbs need to be identified.…”
mentioning
confidence: 99%