Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
In high-risk type 1 diabetes populations, up to 3% of the general population newborns may express islet autoantibodies in cord blood and the vast majority of those appear to be maternal autoantibodies that disappear usually before the age of 9 months. Despite recent progress in standardization of autoantibody assays, some of the findings appear to be artifacts or non-IgG-mediated binding phenomena. It remains unclear whether transplacentally transmitted maternal autoantibodies play any role in protecting the offspring of diabetic women from diabetes. The evidence for fetal production of islet autoantibodies is very limited and remains to be validated in large prospective studies currently underway.
In high-risk type 1 diabetes populations, up to 3% of the general population newborns may express islet autoantibodies in cord blood and the vast majority of those appear to be maternal autoantibodies that disappear usually before the age of 9 months. Despite recent progress in standardization of autoantibody assays, some of the findings appear to be artifacts or non-IgG-mediated binding phenomena. It remains unclear whether transplacentally transmitted maternal autoantibodies play any role in protecting the offspring of diabetic women from diabetes. The evidence for fetal production of islet autoantibodies is very limited and remains to be validated in large prospective studies currently underway.
Environmental factors appear to play an important role in the pathogenesis of childhood-onset type 1 diabetes (T1D). The most important factors are thought to be infectious, dietary, perinatal, and psychosocial. Enteroviruses (especially Coxsackie B virus), breastfeeding, the early presence or lack of certain foods, birth weight, childhood over-nutrition, maternal islet autoimmunity, and negative stress events have been shown to be related to the prevalence of T1D. However, clear conclusions to date are limited because most studies lacked power to detect exposure/disease associations, were not prospective or long-term, did not start in infancy, had imprecise or infrequent exposure estimates, had confounding exposures, and failed to account for genetic susceptibility. In addition to the identification of specific antigenic triggers, several more general hypotheses, including the accelerator and hygiene hypotheses, are testable approaches worth pursuing.
OBJECTIVE -To determine whether the presence of islet autoantibodies in the umbilical cord blood is predictive of subsequent development of islet autoimmunity. RESEARCH DESIGN AND METHODS-Cord blood sera from 1,118 subjects from the Diabetes Autoimmunity Study in the Young (DAISY) cohort, as well as their venous blood samples taken at follow-up clinic visits, were tested for GAD65 autoantibodies (GAAs), insulin autoantibodies (IAAs), and IA-2 autoantibodies (IA-2As). Venous blood samples taken from mothers of cord blood autoantibody-positive children were analyzed for the same autoantibodies.RESULTS -At least one of three islet autoantibodies was present in 42 (3.7%) of the cord blood samples tested. The presence of cord blood autoantibodies did not predict the subsequent development of islet autoimmunity (adjusted hazard ratio ϭ 0. 73 [0.09, 5.88]). Discordance between cord blood and corresponding maternal autoantibodies was seen in 3 of 36 infants. A strong correlation between levels of autoantibody in cord blood and maternal circulation was found for GAA (r 2 ϭ 0.93, P Ͻ 0.001) and IAA (r 2 ϭ 0.89, P Ͻ 0.001) but not IA-2A (r 2 ϭ 0.05, P ϭ 0.19). Cord blood autoantibodies in all but one subject disappeared by 9 months of age.CONCLUSIONS -The presence of cord blood autoantibodies is not predictive of subsequent development of islet autoimmunity. The majority of cord blood autoantibodies appear to result from maternal transmission. Diabetes Care 27:497-502, 2004T ype 1 diabetes is usually preceded by the presence of autoantibodies directed toward pancreatic islet cell antigens. The principle autoantibodies found to be associated with type 1 diabetes include GAD65 autoantibodies (GAAs), IA-2 autoantibodies (IA-2As), and insulin autoantibodies (IAAs) (1). These antibodies can be present months to years before the actual clinical diagnosis of diabetes and can serve as predictive markers of type 1 diabetes (2-5). In some children, islet autoantibodies can be detected in the umbilical cord blood. Although maternal transmission of islet autoantibodies to the newborn is not uncommon (6 -9), it has been suggested that not all autoantibodies found in cord blood result from transplacental transfer, but may instead result from in utero production of diabetes-associated autoantibodies (7,10,11).The relationship of cord blood autoantibodies and islet autoimmunity has been explored in previous studies (12-15). However, to assess the predictive value of cord blood autoantibodies in newborns, large prospective studies would be most useful. Since 1993, the Diabetes Autoimmunity Study in the Young (DAISY) has been prospectively investigating the natural history of islet autoimmunity (IA) in infants and children who are at a moderate to high risk of developing type 1 diabetes. Because of the high predictive value of islet autoantibodies, they can be used as a surrogate end point for type 1 diabetes research. This study was able to take advantage of a large bank of stored cord blood sera from DAISY participants, prospectively foll...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.