Open AccessDiagnostic value of combined islet antigen‐reactive T cells and autoantibodies assays for type 1 diabetes mellitus
Author(s) -
Tang Wei,
Liang Huiying,
Cheng Ying,
Yuan Jiao,
Huang Gan,
Zhou Zhiguang,
Yang Lin
Publication year - 2021
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13440
Subject(s) - medicine , postprandial , diabetes mellitus , autoantibody , type 2 diabetes mellitus , glutamate decarboxylase , endocrinology , type 1 diabetes , islet , antigen , immunology , antibody , enzyme , chemistry , biochemistry
Aims/Introduction Type 1 diabetes mellitus is a T cell‐mediated autoimmune disease. However, the determination of the autoimmune status of type 1 diabetes mellitus relies on islet autoantibodies (Abs), as T‐cell assay is not routinely carried out. This study aimed to investigate the diagnostic value of combined assay of islet antigen‐specific T cells and Abs in type 1 diabetes mellitus patients. Materials and Methods A total of 54 patients with type 1 diabetes mellitus and 56 healthy controls were enrolled. Abs against glutamic acid decarboxylase (GAD), islet antigen‐2 and zinc transporter 8 were detected by radioligand assay. Interferon‐γ‐secreting T cells responding to glutamic acid decarboxylase 65 and C‐peptide (CP) were measured by enzyme‐linked immunospot. Results The positive rate for T‐cell responses was significantly higher in patients with type 1 diabetes mellitus than that in controls ( P < 0.001). The combined positive rate of Abs and T‐cell assay was significantly higher than that of Abs assay alone (85.2% vs 64.8%, P = 0.015). A significant difference in fasting CP level was found between the T + and T – groups (0.07 ± 0.05 vs 0.11 ± 0.09 nmol/L, P = 0.033). Furthermore, levels of fasting CP and postprandial CP were both lower in the Ab − T + group than the Ab − T − group (fasting CP 0.06 ± 0.05 vs 0.16 ± 0.12 nmol/L, P = 0.041; postprandial CP 0.12 ± 0.13 vs 0.27 ± 0.12 nmol/L, P = 0.024). Conclusions Enzyme‐linked immunospot assays in combination with Abs detection could improve the diagnostic sensitivity of autoimmune diabetes.