• Production of diabetes-associated autoantibodies against islet autoantigens (IA-2A, GADA, IAA) in children and adolescents at the stages of type 1 diabetes evolution as a basis of clinical immumological algorithm for preclinical diagnosis of disease
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Production of diabetes-associated autoantibodies against islet autoantigens (IA-2A, GADA, IAA) in children and adolescents at the stages of type 1 diabetes evolution as a basis of clinical immumological algorithm for preclinical diagnosis of disease

SOVREMENNAYA PEDIATRIYA. 2015.2(66):113-118; doi 10.15574/SP.2015.65.113

 

Production of diabetes-associated autoantibodies against islet autoantigens (IA-2A, GADA, IAA) in children and adolescents at the stages of type 1 diabetes evolution as a basis of clinical immumological algorithm for preclinical diagnosis of disease

 

Popova V. V.

SI «V.P. Komisarenko Institute of Endocrinology and Metabolism of Acad Med Sci of Ukraine», Kyiv, Ukraine

 

Purpose: to study the clinical and immunological mechanisms of type 1 diabetes (T1D) pathogenesis on the basis of monitoring the processes of insulin-producing β-cells autoimmune destruction and to develop an algorithm for preclinical diagnosis of disease allowing outline the group of marker positive children with burdened heredity and predicted risk for T1D development.

 

Patients and methods. 450 practically healthy normoglycemic children and adolescents, and 123 patients aged 7–18 years with different T1D courses were examined. An increased titer of diabetes-associated autoantibodies (DAAb), mainly GADA and IA-2A, was revealed in 94 (26.7%) of 366 children with burdened hereditary when the presence of DAAb was detected in them no less than two times, T1D clinical debut was manifested in 49 (52.1%) of them from 6 months to 10 years (30.9±3.2 months). T1D was only developed in a child (0.8%) of 272 (73.3%) DAAb negative children in the same period.

 

Results. The priority was to establish the frequency and dynamics for titers of autoantibodies against GADA, IA-2A and IAA in children and adolescents at the stages of T1D evolution as the most important markers of T1D development and to determine the formula of combined incidence and values of simultaneously elevated titers of DAAb against islet autoantigens, that is IA-2A + GADA, as prevailed DAAb combination to identify the marker positive patients at different periods of T1D formation and development that predict the course of preclinical stage of T1D development as well as the rate of disease debut.

 

Conclusion. It was established that the degree of relationship and parents gender, and value of simultaneously elevated titers of autoantibodies — IA-2A and GADA at preclinical period of T1D development detect the frequency and rate of T1D debut in DAAb positive children who have relatives of the first line with T1D.

 

Key words: type 1 diabetes, children and adolescents, diabetes-associated autoantibodies (DAAb), autoantibodies against glutamic acid decarboxylase (GADA), autoantibodies against protein tyrosine phosphatase (IA-2A).

 

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