Your information is correct. There is a lot of interest in these
autoantibodies in Australia with large ongoing prospective studies in
several centres. Anti-GAD, ICA and IA-2 are being used to predict which
relatives of newly diagnosed type 1 diabetics are at risk and interventions
to slow or prevent development of diabetes are being tested. The presence
of one or more of these antibodies is a marker for current or future type 1
diabetes. There is lot of information on Medline e.g. the abstract below.
1: Diabetes Res Clin Pract. 1996 Oct;34 Suppl:S125-31.
Antibodies to glutamic acid decarboxylase in the prediction of insulin
dependency.
Zimmet P.
International Diabetes Institute, Melbourne, Australia.
Antibodies to glutamic acid decarboxylase (anti-GAD) predict the
progression of
adults masquerading as NIDDM to insulin dependency and predict the eventual
occurrence of IDDM in healthy pregnant women in Finland. Almost 80% of
prediabetic and newly diagnosed IDDM cases are positive for anti-GAD.
However,
approximately 20% of these groups do not have a humoral response to GAD so
it
cannot be claimed that anti-GAD is the exclusive autoimmune phenomenon.
Nevertheless, 94% of children with newly diagnosed IDDM that we studied had
an
autoimmune response to either GAD, ICA or IAA, singly or in combination.
The
anti-GAD assay also has a substantial role in the diagnosis and
classification
of diabetes presenting in adult life since a proportion of adults who
present
with apparent NIDDM actually have a slowly evolving autoimmune insulitis, a
condition we have called latent autoimmune diabetes in adults (LADA). It
appears
likely that anti-GAD will be predictive for IDDM in both first degree
relatives
and the general population. As a result of the cost and relative ease of
performance, it will provide a practical alternative to ICA, particularly
in
population screening. Comparisons of testing for anti-GAD and ICA as
predictors
of IDDM using large population groups are now in progress in our
laboratory.
Publication Types:
Review
Review, Tutorial
PMID: 9015681 [PubMed - indexed for MEDLINE]
****************************************
Bruce Campbell FRCPA FAACB
Sullivan Nicolaides Pathology
Ph 61 (0)7 3377 8672
Fax 61 (0)7 3870 5989
Email [log in to unmask]
****************************************
Peter Stromberg
<[log in to unmask] To: [log in to unmask]
T.NHS.UK> cc:
Sent by: Clinical Subject: GLUTAMIC ACID DECARBOXYLASE /ANTIBODIES
biochemistry discussion
list
<ACB-CLIN-CHEM-GEN@JISCM
AIL.AC.UK>
13/06/03 20:50
Please respond to Peter
Stromberg
The story goes that the above test may be of use in the differentiation of
types 1 and 11 diabetes mellitus in our case in a child. Do any of our
listeners know a lot about this ,and if it is true ( even evidence based
dare I say it) ,where the test could be done and what the sample handling
requirements are? For my continuing education some references would be
appreciated.
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