Detection of Antibodies Directed to the N-Terminal Region of GAD Is Dependent on Assay Format and Contributes to Differences in the Specificity of GAD Autoantibody Assays for Type 1 Diabetes.

Abstract:

:GAD autoantibodies (GADAs) are sensitive markers of islet autoimmunity and type 1 diabetes. They form the basis of robust prediction models and are widely used for the recruitment of subjects at high risk of type 1 diabetes to prevention trials. However, GADAs are also found in many individuals at low risk of diabetes progression. To identify the sources of diabetes-irrelevant GADA reactivity, we analyzed data from the 2009 and 2010 Diabetes Autoantibody Standardization Program GADA workshop and found that binding of healthy control sera varied according to assay type. The characterization of control sera found positive by radiobinding assay (RBA), but negative by ELISA, showed that many of these sera reacted to epitopes in the N-terminal region of the molecule. This finding prompted development of an N-terminally truncated GAD65 radiolabel, (35)S-GAD65(96-585), which improved the performance of most GADA RBAs participating in an Islet Autoantibody Standardization Program GADA substudy. These detailed workshop comparisons have identified a source of disease-irrelevant signals in GADA RBAs and suggest that N-terminally truncated GAD labels will enable more specific measurement of GADAs in type 1 diabetes.

journal_name

Diabetes

journal_title

Diabetes

authors

Williams AJ,Lampasona V,Schlosser M,Mueller PW,Pittman DL,Winter WE,Akolkar B,Wyatt R,Brigatti C,Krause S,Achenbach P,Participating Laboratories.

doi

10.2337/db14-1693

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

3239-46

issue

9

eissn

0012-1797

issn

1939-327X

pii

db14-1693

journal_volume

64

pub_type

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