oCtoBeR 2010 - American Association for Clinical Chemistry

figure 1
stratification of diabetes risk
a. Based on Numbers of Autoantibodies b. Based on Autoantibody Combination
developing T1D. When an effective way
to reintroduce tolerance in autoimmune
diabetes becomes available, high-quality,
high-throughput autoantibody tests will
be essential for identifying individuals who
can benefit from such treatment.
Future therapeutic intervention trials
for disease will need to consider the characteristics
of the population and assay performance
in screening for the disease. These
strategies will likely evolve as researchers
devise new interventions and develop new
tests. Two early intervention trials for which
recruitment was based on ICA and/or IAA
have already proven the efficacy of islet autoantibodies
for T1D prediction (18, 19).
Researchers have also used the presence of
IAA, GADA, and IA-2A as a criterion for recruiting
individuals into prevention studies
and for identifying initiation of autoimmunity
in natural history studies of T1D, such
as the The Environmental Determinants of
Diabetes in the Young (TEDDY) Study. CLN
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10 CliniCal laboratory news oCtoBeR 2010
c. Based on IA-2A Epitopes
stratification of diabetes risk in islet autoantibody (iaa, gada, and/or ia-2a)-positive first-degree relatives of t1d patients (n = 180) based on
autoantibody number (a), target antigen specificity (b), and ia-2a reactivity against ia-2β (c).
Reprinted with permission from The American Diabetes Association. Copyright 2004, from Diabetes 2004;53:384–392.
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Patricia W. Mueller, PhD, is chief of the
Molecular Risk Assessment Laboratory at the
Centers for Disease Control and Prevention,
Atlanta, Ga. Address all correspondence to:
pwm2@cdc.gov.
Peter Achenbach, MD, is a physician
and clinical scientist at the Institute of
Diabetes Research, Helmholtz Center,
Munich, Germany.
Vito Lampasona is a senior scientist at the
Center of Genomics, Bioinformatics, and
Biostatistics, San Raffaele Scientific Institute,
Milan, Italy.
Michael Schlosser is a senior scientist in
medical biochemistry and molecular
biology, University of Greifswald,
Karlsburg, Germany.
Alistair J. K. Williams is a research fellow in
clinical science at North Bristol, University of
Bristol, Bristol, U.K.