Research of anti-GAD and anti-IA2 autoantibodies by ELISA test in a series of Moroccan pediatric patients with diabetes type 1

Abstract

Introduction: Type I diabetes (T1D) is an autoimmune disease with a prediabetic, asymptomatic period characterized by the selective destruction of insulin-producing β cells. During the pre-clinical phase, various auto-antibodies are generated against several beta cell antigens such as anti glutamate acid decarboxylase (Anti-GAD), anti tyrosine phosphatase (Anti-IA2). Today, the coupled detection of Anti-IA2 with that of Anti-GAD proves its great importance in the diagnosis and prediction of type 1 diabetes. The combined positivity for both antibodies has a specificity and a positive predictive value of 100%.
 Objectives: In this work, we evaluate the diagnostic value of anti-GAD and anti-IA2 antibodies in a series based on 78 Moroccan subjects initially under 16, suspected T1D.
 Results and Discussion: Our series consists mainly of 74% of newly diagnosed patients for T1D and 26% of confirmed diagnostic patients, of whom 52% are females. The mean age of diagnosis is 7 ± 4 years, the mean of HbA1c at the time of diagnosis is 11.63 ± 2.16%, and the percentage of family history in our series is 69%. The proportion of positive results for anti-IA2 antibodies and anti-GAD antibodies are, respectively, 76.92% and 62.82%, and 52.56% of patients are positive for both auto-antibodies. This study confirms that anti-GAD and anti-IA2 auto-antibodies assays can detect patients early and the autoantibodies can persist several years after diagnosis of type 1 diabetes.
 Conclusion: This study confirmed the diagnosis and classification of T1D (type 1A) in 87.18% of patients, and we reported that the prevalence of anti-GAD and anti-IA2 is higher in girls than in boys.
 Keywords: Type 1 diabetes; autoimmunity; autoantibodies; anti-GAD; anti-IA2; ELISA; classification.

ASSOCIATION OF ANTI-COXSACKIE VIRUS-B IgG WITH AUTOANTIBODIES RELATED TO TYPE 1 DIABETES MELLITUS

“…T1DM had greater levels of anti-IA2, anti-ICA, and GAD65 antibodies than healthy controls. Zamanfar et al in Iran (9) , Basu et al in India (10) , Belhibaet al in Morocco (11) , and Bravis et al in the United Kingdom (13) all came to a similar result. Beta cell autoimmunity is defined by the presence of diabetes-associated autoantibodies in the bloodstream, which indicates that the cells are being attacked.…”

“….75 U/ml and 58.6 U/ml, respectively compared with 34.6 U/ml, 31.9 U/ml and 43.7 U/ml, respectively, in patients negative for anti-CoxV-B IgG antibodies with highly significant differences (Table 3). (10) , Belhiba et al in Morocco (11) , have reported positive correlations between FBS, HbA1c, and fructosamine values with diabetic patients. According to the data, HbAlc has been found to be a strong predictor of fructosamine.…”

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“…A study conducted in a group of 78 Moroccan children with type 1 diabetes, all under the age of 16, revealed the presence of anti-GAD antibodies in approx. 63% of them, anti-IA2 in 77%, and simultaneously both of the same in 53% of the subjects, notably more commonly in girls [89]. In an Iranian study, the presence of antibodies was confirmed in over 80% of children and adolescents with type 1 diabetes, primarily ICA and Anti-GAD [91].…”

“…In the case of auto-aggression, the signal inducing the immune response may originate from an inflammation accompanying the release of antigens due to damage [88]. The immunological markers of type 1 diabetes include antibodies active against pancreatic β cells: Islet-cell antibodies (ICA), insulin autoantibodies (IAA), anti-glutamine acid decarboxylase (anti-GAD), anti-zinc transporter protein 8 (anti-ZnT8), and anti-tyrosine phosphatase antibodies (anti-IA2) [89]. They are detectable many months before clinical symptoms of diabetes, signify the humoral immune response against Langerhans's pancreatic β islet-cells, and are considered to be markers of pancreatic cell destruction.…”

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“…And from Morocco 39 we a paper on: “anti-GAD and anti-IA2 autoantibodies by ELISA test in a series of Moroccan paediatric patients with type 1 diabetes.” Tackling a social angle of diabetes, a paper from South Africa 40 documents “socio-demographic and modifiable risk factors of diabetes and hypertension among resource constrained patients from rural areas in Mdantsane Township.”…”