Anticorpos anti-GAD - lndicações na prática clínica
Palavras-chave:
anticorpos anti-GAD, diabetes tipo l, auto-imunidadeResumo
A etiopatogenia da diabetes tipo l ( caracterizada por défice absoluto em insulina) resulta de um processo auto-imune dirigido contra a célula f3. Ocorre num terreno de susceptibilida de genética, sendo despoletado por factores ambienciais.
O reconhecimento da diabetes tipo l como doença auto-imune baseia-se, quer no reconhecimento da insulite (infiltrado inflamatório linfo citário do ilhéu) quer na descoberta de numero sos anticorpos dirigidos contra constituintes das células f3 dos ilhéus de Langerhans. A fase de agressão auto-imune pré-clinica é caracteriza da pelo aparecimento de vários anticorpos, dos quais se destacam: lCA, lAA e anti-GAD. Os anti corpos anti-GAD, pela sua especificidade, são actualmente considerados os marcadores de auto imunidade mais importantes na diabetes tipo I. A sua detecção na fase pré-clinica de doença permite determinar futura insulinodependência, sendo especialmente útil no diagnóstico diferen cial da diabetes do adulto jovem não obeso e na diabetes gestacional. A sua determinação poderá também vir a revelar-se importante na pre venção primária da diabetes através da utilização de antigenioterapia especifica.
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