Anti-GAD antibodies - lndicatious in clinical practice
Keywords:
antibodies anti-GAD, type 1 diabetes, autoimmunityAbstract
The pathogenesis of type 1 diabetes ( characte rized by insulin deficiency) is caused by an auto immune process against the pancreatic islet f3 cells. lt occurs when a genetic susceptibility in teracts with multiple environmental agents. The evidence for an auto-immune basis comes from the recognition of insulitis and the presence of multiple auto-antibodies to {3-cell constituents. ln the early pre-clinical phase of type l diabetes, antibodies to islet cell antigens are detected, in cluding: lCA (islet cell antibodies), lAA (insulin auto-antibodies) and anti-GAD (glutamic acid decarboxylase antibodies). The anti-GAD antibody is the main auto-immune marker. When detected in the pre-clinical phase of disease, it allows us to predict future insulin dependency. lts contribution to the classification oftype l diabetes in the young non-obese adult and in gestacional diabetes is discussed. ln the future the utilisation of anti-GAD could be useful in primary pre vention with antigen immunotherapy.
Downloads
References
Atkinson MA, Maclaren NK. The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 1994; 331: 1428-
Bottazzo GF, Florin-Christensen A, Doniach D. Islet-cell anti bodies in diabetes mellitus with autoimmune plyendocrine deficiencies. Lancet 1974; ii: 1279-1283.
Baekkeskov S, Landin M, Kristensen JK et al. Antibodiesto a 64000 Mr human islet cell antigen precede the clinical onset of insulin-dependent diabetes.J Clin Invest 1987; 79: 926-934.
Atkinson MA, Maclaren NK, Sharp DW et al. 64000Mr autoantibodies as predictors of insulin-dependent diabetes. Lancet 1990; 335: 1357-1360.
Baekkeskov S, Aanstoot HJ, Christgau S et al. Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA- synthesizing enzyme glutamic acid decarhoxylase. Nature 1990; 347: 151-156.
Erlander MG, Tillakaratne NJ, Feldhlum S et al. Two genes encode distinct glutamate decarboxylases. Neuron 1991; 7: 91-100.
Bu DF, Erlander MG, Tillakaratne NJ, te al. Two glutamate decarboxylases, 65 kDa GAD and 67 kDa GADare each encoded by a single gene. Proc Natl Acad Sci USA 1992; 89: 2115- 2119.
Hagopian WA, Michelsen B, Karlsen AE et ai. Autoantibodies in IDDM primarily recognize the 65000Mr rather than the 67000Mr isoform of glutamic acid decarboxylase. Diabetes 1993; 42: 631-636.
Solimena M, Folli F, Denis-Donini S et al. Autoantibodies to glutamic acid decarboxylase in a patient with stiff-man syndrome, epilepsy, and Type 1 diabetes mellitus. N Engl J Med 1988; 318: 1012-1020
O. Solimena M, Folli F, Aparisi R et al. Autoantihodies to GABA ergic neurons and pancreatic heta cells in stiff-man syndro me. N Engl J Med 1990; 322: 1555-1560.
Szopa TM, Titchener PA, Partwood ND et al. Diabetes mellitus due to viruses- some recent developments. Diabetologia 1993; 36: 687-695.
Kaufman DL, Erlander MG, Clare-Salzler M, Atkinson MA, Madaren NK, Tohin AJ. Autoimmunity to two forms of glutamate decarboxylase in insulin-dependent diabetes mellitus. J Clin Invest 1992; 89: 283-292.
Serjeant,on SW, Kohonen-Corish MR, Rowley MJ et al. Antibodies to glutamic acid decarboxylase are associated with HLA DR genotypes in both Australians and Asians with Type 1 diabetes mellitus. Diabetologia 1992; 35: 996-1001.
National Diabetes Data Group: Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979; 28: 1039-1057.
Molhac AC, Christau B, Marner B et al. lncidence of insulin dependent diabetes mellitus in age groups over 30 years in Denmark-Diahetic Med 1994; 11: 650-655.
Groop LC, Bottazzo GF, Doniach D. Islet cell antihodies identify latent type 1 diabetes in patients aged 35-75 years at diagnosis. Diabetes 1986; 35: 237-241.
Tuomi T, Groop LC, Zimmet PZ et al. Antibodies to glutamic acid decarboxylase reveal latent autoimmune diabetes mellitus in adults with a non-insulin-dependent onset of disease. Diabetes 1993; 42: 359-362.
Zimmet P, MD, PHD . The pathogenesis and prevention of diabetes in adults. Diabetes Care 1995; 18; (7): 1050-1064.
Zimmet P: Type 2 (non-insulin-dependent) diahetes- an epidemiological overview. Diabetologia 1982; 22: 399-411.
Dussoix P, Vaxillaire M, Patrick B et ai. Diagnostic heteroge neity of diabetes in Jean young adults- dassification based on immunological and genetic parameters. Diabetes 1997; 46: 622-631.
Zimmet PZ, Tuomi T, Mackay IR et al. Latent autoimmune diabetes mellitus in adults ( LADA ): the role of antihodies to glutamic acid decarboxylase in diagnosis and prediction of insulin dependency. DiabeticMed 1994; 11: 299-303.
Thivolet CH, Tappaz M, Durand A et al. Glutamic acid decar boxylase autoantihodies are additional predictive markers of Type 1 diabetes mellitus in hight risk individuals. Diabetologia 1992; 35: 570-576.
Zimmet PZ, Elliot RB, Mackay IR et al. Autoantibodies to gluta mic acid decarhoxylase and insulin in islet cell antihody positive presymptomatic Type 1 diahetes mellitus: frequency and segregation by age andgender. Diabetic Med 1994; 11: 866-871.
Palmer JP. What is the best way to predict IDDM. Lancet 1994; 343, 8910: 1377-1378.
Rowley MJ, Mackay IR, Chen QY et al. Antibodies to glutamic acid decarhoxylase discriminate major types of diabetes mellitus. Diabetes 1992; 41: 548-551
Batstra M, Pina M, QuanJ et al. Flutuations in GAD 65 antiho dies after clinical diagnosis of IDDM in young children. Diabetes Care 1997; 20 (4): 642-644.
Chen QY, Rowley MJ, Byrne GC et al. Antihodies to glutamic acid decarhoxylase in Australian children with insulin-dependent diabetes mellitus and their first degree relatives. Pediatr Res 1993; 34: 785-790.
Petersen J, Dyrherg T, Damm P et al. GAD65 autoantibodies in woman with gestational or insulindependent diabetes mellitus diagnosed during pregnancy. Diabetologia 1996; 39: 1329-1333.
Tuomilehto J, Zimmet P, MacKay IR et al. Antihodies to glutamic acid decarboxylase as predictors of insulindependent diabetes mellitus before clinical onset of disease. Lancet 1994; 343: 1383-1385.
Keller RJ, Eisenbarth GS, Jackson RA. lnsulin prophylaxis in individuais at risk of type 1 diabetes. Lancet 1993; 341: 927-
Additional Files
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
