Summary
Antibodies directed against a beta-cell specific antigen with a molecular weight of 37 kDa have recently been described. These anti-37kDa antibodies were measured by the immunoprecipitation technique in individuals at risk for insulin-dependent diabetes mellitus (IDDM), with islet cell antibodies (ICA) greater than 20 Juvenile Diabetes Foundation units (JDFU). These subjects were recruited from large population-based cohorts at various degrees of risk for developing the disease before adulthood. Anti-37kDa antibodies were measured in 25 ICA-positive first degree relatives with ICA greater than 20 JDFU, identified from a baseline cohort of 1,185 relatives (age: 0–75 years). Four relatives were positive for anti-37kDa antibodies since the first determination onwards. These relatives developed IDDM in a 2-year follow-up period. We included 300 children with an IDDM parent, and aged less than 7 years, in a prospective survey for the prediction of IDDM. Five (1.6%) showed ICA greater than 20 JDFU. None of them were found to be positive for anti-37kDa antibodies, and none have progressed to diabetes during a 2-year follow-up. Among a baseline cohort of 13,380 schoolchildren (age: 6–17 years), 28 (0.2%) were found to have ICA greater than 20 JDFU. One boy was positive for anti-37kDa antibodies on two consecutive occasions and developed IDDM after a 10-month follow-up. No other schoolchildren with ICA greater than 20 JDFU were found to be positive for anti-37kDa antibodies. Altogether 40 other ICA-positive sera (with titres <20 JDFU) were found to be negative for anti-37kDa antibodies. With our assay, anti-37kDa antibodies were found to have a 76% sensitivity (95%CI: 68–92%) at the time of diagnosis in diabetic children. The current observations are based on a short-term follow-up. An analysis based on a longer period will be extremely useful for the prediction of IDDM and the appearance of anti-37kDa antibodies.
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Abbreviations
- IDDM:
-
insulin-dependent diabetes mellitus
- ICA:
-
islet cell antibodies
- IAA:
-
insulin auto-antibodies
- JDFU:
-
Juvenile Diabetes Foundation unit
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Ongagna, J.C., Levy-Marchal, C. Anti-37kDa antibodies are associated with the development of IDDM in individuals with islet cell antibodies. Diabetologia 38, 370–375 (1995). https://doi.org/10.1007/BF00400644
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DOI: https://doi.org/10.1007/BF00400644