Comparing the clinical significance and antigen specificity of insulinoma-associated antigen-2 autoantibodies between radioimmunoassay and enzyme-linked immunosorbent assay in Japanese patients with type 1 diabetes

被引：5

作者：

Kawasaki, Eiji ^{[1
]}

Shimada, Akira ^{[2
]}

Imagawa, Akihisa ^{[3
]}

Abiru, Norio ^{[4
]}

Awata, Takuya ^{[5
]}

Oikawa, Yoichi ^{[2
]}

Osawa, Haruhiko ^{[6
]}

Kawabata, Yumiko ^{[7
]}

Kozawa, Junji ^{[8
]}

Kobayashi, Tetsuro ^{[9
]}

Takahashi, Kazuma ^{[10
]}

Chujo, Daisuke ^{[11
]}

Fukui, Tomoyasu ^{[12
]}

Miura, Junnosuke ^{[13
]}

Yasuda, Kazuki ^{[14
]}

Yasuda, Hisafumi ^{[15
]}

Kajio, Hiroshi ^{[16
]}

Hanafusa, Toshiaki ^{[17
]}

Ikegami, Hiroshi ^{[7
]}

机构：

[1] Shin Koga Hosp, Diabet Ctr, Kurume, Fukuoka, Japan

[2] Saitama Med Univ, Sch Med, Dept Endocrinol & Diabet, Iruma, Saitama, Japan

[3] Osaka Med & Pharmaceut Univ, Dept Internal Med 1, Takatsuki, Osaka, Japan

[4] Nagasaki Univ Hosp, Dept Endocrinol & Metab, Nagasaki, Japan

[5] Natl Ctr Global Hlth & Med, Pancreat Islet Cell Transplantat Ctr, Tokyo, Japan

[6] Ehime Univ, Dept Diabet & Mol Genet, Grad Sch Med, Toon, Japan

[7] Kindai Univ, Dept Endocrinol Metab & Diabet, Fac Med, Osaka, Japan

[8] Osaka Univ, Grad Sch Med, Dept Metab Med, Suita, Osaka, Japan

[9] Okinaka Mem Inst Med Res, Tokyo, Japan

[10] Iwate Prefectural Univ, Takizawa, Japan

[11] Toyama Univ Hosp, Ctr Clin Res, Toyama, Japan

[12] Showa Univ, Div Diabet & Endocrinol, Sch Med, Tokyo, Japan

[13] Tokyo Womens Med Univ, Dept Internal Med, Div Diabetol & Metab, Sch Med, Tokyo, Japan

[14] Kyorin Univ, Dept Diabet Endocrinol & Metab, Mitaka, Tokyo, Japan

[15] Kobe Univ, Dept Publ Hlth, Div Hlth Sci, Grad Sch Hlth Sci, Kobe, Hyogo, Japan

[16] Natl Ctr Global Hlth & Med, Dept Diabet Endocrinol & Metab, Tokyo, Japan

[17] Sakai City Med Ctr, Sakai, Osaka, Japan

来源：

JOURNAL OF DIABETES INVESTIGATION | 2023年 / 14卷 / 01期

关键词：

Autoantibodies; Autoantigen; Insulinoma-associated antigen-2; Type; 1; diabetes; ANTIBODY STANDARDIZATION PROGRAM; GLUTAMIC-ACID DECARBOXYLASE; ACUTE-ONSET; DIAGNOSTIC-CRITERIA; AUTOIMMUNE; MELLITUS; REQUIREMENT; COMMITTEE; FULMINANT; SOCIETY;

D O I：

10.1111/jdi.13910

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims/Introduction This study aimed to investigate the clinical significance and antigen specificity of autoantibodies to insulinoma-associated antigen-2 (IA-2A) by radioimmunoassay (RIA; IA-2A-RIA) and enzyme-linked immunosorbent assay (ELISA; IA-2A-ELISA) in Japanese patients with type 1 diabetes. Materials and Methods A total of 338 type 1 diabetic patients were enrolled, including 38 fulminant type 1 diabetes, 168 acute-onset type 1 diabetes and 137 slowly-progressive type 1 diabetes (SPIDDM). The concordance, correlation of autoantibody titer, and the relationship between IA-2A and progression to the insulin-deficient state were examined. Also, competitive assay was used to examine the antigen specificity. Results The prevalence of IA-2A-ELISA was 4-5% lower than that of IA-2A-RIA in both the acute-onset type 1 diabetes and SPIDDM, but the diagnostic sensitivities of both subtypes, when measured in combination with glutamic acid decarboxylase autoantibody, were comparable. The diagnosis of type 1 diabetes using either the RIA or ELISA methods showed substantial agreement with the exponential correlation of autoantibody titers detected by RIA and ELISA. Among the SPIDDM patients, the fasting C-peptide for IA-2A-positive cases by ELISA, but not the RIA method, was significantly lower than in the negative cases (P < 0.05). Furthermore, IA-2A-ELISA proved superior to the RIA method in predicting the progression to insulin deficiency in SPIDDM. Competitive analysis showed that even sera with discrepant results by RIA and ELISA have IA-2-specific autoantibodies. Conclusion These results suggest that IA-2A-ELISA is a reliable marker not only for the diagnosis of type 1 diabetes, but also for the prediction of future insulin dependency; that is, detection of IA-2A-ELISA helps identify a subtype of SPIDDM patients who would likely progress onto insulin-deficient state.

引用

页码：58 / 66

页数：9

共 16 条

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