Detection of antibodies directed to the N-terminal region of GAD is dependent on assay format and contributes to differences in the specificity of GAD autoantibody assays for type 1 diabetes: Improved specificity of autoantibodies to N-terminally truncated GAD

Alistair Williams, Vito Lampasona, Schlosser Michael, Patricia Mueller, David Pittman, William Winter, Beena Akolkar, Rebecca Wyatt, Cristina Brigatti, Stephanie Krause, Peter Achenbach

Research output: Contribution to journalArticle (Academic Journal)peer-review

30 Citations (Scopus)
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Abstract

Autoantibodies to glutamate decarboxylase (GADA) are sensitive markers of islet autoimmunity and type 1 diabetes. They form the basis of robust prediction models and are widely used for recruitment of subjects at high risk of type 1 diabetes to prevention trials. However GADA are also found in many individuals at low risk of diabetes progression. To identify the sources of diabetes irrelevant GADA reactivity therefore, we analyzed data from the 2009 and 2010 Diabetes Autoantibody Standardization Program GADA workshop and found that binding of healthy control sera varied according to assay type. Characterization of control sera found positive by radiobinding assay, but negative by ELISA showed that many of these sera reacted to epitopes in the N-terminal region of the molecule. This finding prompted development of an N-terminally truncated GAD65 radiolabel, 35S-GAD65(96-585), which improved the performance of most GADA radiobinding assays (RBAs) participating in an Islet Autoantibody Standardization Program GADA substudy. These detailed workshop comparisons have identified a source of disease-irrelevant signals in GADA RBAs and suggest that N-terminally truncated GAD labels will enable more specific measurement of GADA in type 1 diabetes.
Original languageEnglish
Pages (from-to)3239-3246
Number of pages18
JournalDiabetes
Volume64
Issue number9
Early online date13 May 2015
DOIs
Publication statusPublished - Sep 2015

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