Islet Cell Autoantibodies: Which Method?

Kolb, Hubert; Krügener, Gabriele; Gries, F. A.; Bellmann, O.; Clark, Anne; Smith, Donald; Chapel, Helen

doi:10.1016/s0140-6736(83)91481-2

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…with or without secondary dia betes. In spite of some known methodologi cal problems [16], we agree with Violettes et al [I 7] that these antibodies are probably of little importance in the development of sec ondary diabetes in CP.…”

Section: Discussionsupporting

confidence: 90%

Antitissue Antibodies in Chronic Pancreatitis

Emanuelli

Tappero²,

Iuliano³

et al. 1989

Digestion

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Organ- and nonorgan-specific autoantibodies (AA) have been investigated in 49 patients affected by alcoholic or idiopathic chronic pancreatitis (CP) to evaluate their prevalence and correlation with the clinical features of the disease. AA have been found in about 50% of CP and their recurrence rate was similar to that of alcoholic or cryptogenic liver cirrhosis (LC); age- and sex-matched healthy subjects (C) showed only about 8% positive sera (C vs. CP, p < 0.001). Quite different IFL patterns between CP and LC have been detected. Antibrush border, antireticulin and antigastric parietal cell antibodies alone or combined prevailed in CP, while antinuclear and antismooth muscle AA prevailed in LC. No correlation with sex, age, etiology, presence of pancreatic stones, diabetes, symptoms and years of CP was found for one or more AA. In conclusion, the detection of AA in CP is a quite common finding of still unclear clinical significance.

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Section: Discussionsupporting

confidence: 90%

Antitissue Antibodies in Chronic Pancreatitis

Emanuelli

Tappero²,

Iuliano³

et al. 1989

Digestion

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“…In summarizing the ICA-frequency data in nondiabetic subjects from several cross-sectional studies published, 0-3.7% (mean 0.42%, 64/15,083 of nondiabetic subjects studied for ICA) were IF-ICA + . However, most screenings have been based on small numbers and a wide age distribution (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(23)(24)(25), and the results have not been evaluated regarding JDF units, except in one of them in which samples from 321 individuals contained a median ICA level of 27 JDF U (range 17-1200 JDF U; 14). Another study found a range of ICA levels of only 5-10 JDF U in eight nondiabetic individuals (21).…”

Section: Discussionmentioning

confidence: 99%

“…The exclusion of these 2 subjects still give an IF-ICA prevalence of 4.0% (48/1212) and a CF-ICA prevalence of 0.9% (11/1212). Other possible factors responsible for the variability of the results might be related to methodological differences between different laboratories, especially substrate-related factors (10,29,40) and to interobserver variation (40).…”

Section: Discussionmentioning

confidence: 99%

“…In various populations, the average frequency of ICA positivity in nondiabetic subjects has been -0.5% . Most studies have been based on the detection of conventional ICAs (IF-ICAs) in small groups of individuals with varying age distribution (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Current studies favor the view that, rather than being related to the pathogenesis itself, ICAs are secondary markers of ongoing p-cell damage, which eventually results in the clinical manifestation of IDDM in at least some individuals (26).…”

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confidence: 99%

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Islet Cell Antibodies as Predictive Markers for IDDM in Children With High Background Incidence of Disease

Karjalainen

1990

Diabetes

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To determine the prevalence and predictive value of islet cell antibodies (ICAs) for the development of insulin-dependent diabetes mellitus (IDDM) in 1212 Finnish children aged 3-18 yr, samples for ICA determination were taken in 1980, and subsequent analyses were performed in originally ICA+ children and in 296 initially ICA- children in 1983 and 1986. All 1212 subjects were followed for 8 yr for the development of IDDM. Fifty children (4.1%) were positive for conventional ICAs (IF-ICAs) in 1980 (range 3-80 Juvenile Diabetes Foundation units [JDF U]; median 30 JDF U), of which 12 (1.0%) had complement-fixing ICAs (CF-ICAs) in their serums (range 3-30 JDF U; median 8 JDF U). None were exclusively CF-ICA+. Boys were CF-ICA+ more often than girls (9 of 563 [1.6%] vs. 3 of 649 [0.5%], respectively; P less than 0.05). Over the next 6 yr, 4 of 39 subjects lost their IF-ICAs, and 4 of 12 lost their CF-ICAs without progressing to diabetes. The initial IF-ICA levels in these subjects were lower (range 3-8 JDF U; median 7 JDF U; P less than 0.05) than those in the persistent cases. In the initially ICA- subgroup (n = 296), 7 subjects (2.4%) later became IF-ICA+, and 4 (1.4%) became CF-ICA+. The levels of ICA in these subjects were lower than in the originally ICA+ ones (P less than 0.05), and 3 IF-ICA+ and 2 CF-ICA+ subjects again became ICA- before 1986.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…ICA-IgG and CF-ICA were detected by indirect immunofluorescence, using cryostat sections of human pancreas [6][7][8]. HLA-DR1, 2, 3, 4, 5, W6, 7, W8 and W10 specificities were recognized on peripheral B-lymphocytes [9].…”

Section: Meno~mentioning

confidence: 99%

Correlation of islet cell antibodies and HLA-DR phenotypes with diabetes mellitus in adults

et al. 1984

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Summary.In a cross-sectional study, sera of 81 adult diabetic in-patients were tested for the presence of pancreatic islet cell antibodies (ICA), both IgG and complement-fixing. All patients had been well controlled initially with oral hypoglycaemic agents and therefore had been classified as having Type 2 (non-insulin-dependent) diabetes. However, 14 were subsequently classified as Type 1 (insulin-dependent) because they became insulin-dependent within 2 months of diagnosis. Ten of these patients (71%) were ICA-positive. Sixty-seven patients had been non-insulin-dependent for at least 1 year after diagnosis. Circulating ICA were present in 18 patients and 16 of these (89%) required insulin therapy. Secondary oral hypoglycaemic agent failure developed within a mean period of 3.7 years after diagnosis. In contrast, in the ICA-negative subgroup (n = 49) insulin treatment became necessary in 29 patients. Secondary oral hypoglycaemic agent failure of these patients had developed after a mean period of 8.4years, which was significantly longer than in the ICA-positive patients (p < 0.01). Complement-fixing-ICA were detected only in sera with an ICA-IgG titre of at least 8, and its prevalence was similar in the sub-groups tested, i.e., the Type I diabetic patients and the patients with secondary oral hypoglycaemic agent failure. With HLA-DR typing, a significant excess of the DR3 antigen and heterozygous DR3/DR4 phenotypes was found in ICA-positive patients with secondary oral hypoglycaemic agent failure and in the Type 1 diabetic patients, which was comparable with the frequencies reported in juvenileonset Type 1 diabetes. The heterozygous DR3/W6 phenotype was significantly increased in the ICA-positive patients when compared with 13 ICA-negative patients. Thus, the presence of ICA and an excess of certain HLA-DR phenotypes identify a sub-group within the adult diabetic population with secondary oral hypoglycaemic agent failure which can be regarded as a retarded form of Type I diabetes.Key words: Islet cell antibody, complement-fixing islet cell antibody, HLA-DR phenotypes.Cytoplasmic antibodies to pancreatic islet cells (ICA) have been described in adult diabetic patients treated with oral hypoglycaemic agents and are associated with a high probability of becoming insulin-dependent within the near future. Considering the heterogeneity of diabetes, ICA-positive, apparently non-insulin-dependent diabetes may represent a retarded pathogenesis of Type I (insulin-dependent) diabetes [1,2]. This is supported by the observation that ICA-positive patients, even though initially controlled with oral hypoglycaemic agents, expressed a significant prevalence of HLA-DR3 and heterozygous DR3/DR4 phenotypes comparable with the frequencies found in juvenile onset Type 1 diabetes [3][4][5]. Subjects and methods SubjectsEighty-one patients (aged 30-75 years, mean_+ SEM age 50_+ 1 years) were initially well controlled with diet or additional oral hypoglycaemic agents and, therefore, had been classified as having Type 2 (noninsulin-dep...

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Islet Cell Autoantibodies: Which Method?

Cited by 12 publications

References 16 publications

Antitissue Antibodies in Chronic Pancreatitis

Antitissue Antibodies in Chronic Pancreatitis

Islet Cell Antibodies as Predictive Markers for IDDM in Children With High Background Incidence of Disease

Correlation of islet cell antibodies and HLA-DR phenotypes with diabetes mellitus in adults

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