Is Presence of Islet Autoantibodies at Birth Associated With Development of Persistent Islet Autoimmunity?

• Published in: Diabetes care Vol. 27; no. 2; pp. 497 - 502
• Main Authors: Stanley, Heather M., Norris, Jill M., Barriga, Katherine, Hoffman, Michelle, Yu, Liping, Miao, Dongmei, Erlich, Henry A., Eisenbarth, George S., Rewers, Marian
• Format: Journal Article
• Language: English
• Published: Alexandria American Diabetes Association 01.02.2004
• Subjects: Autoimmune diseases; Babies; Blood; Diabetes; Immune system
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.27.2.497

Is Presence of Islet Autoantibodies at Birth Associated With Development of Persistent Islet Autoimmunity? The Diabetes Autoimmunity Study in the Young (DAISY) Heather M. Stanley , MSPH 1 , Jill M. Norris , MPH, PHD 1 , Katherine Barriga , MSPH 1 , Michelle Hoffman , RN 1 , Liping Yu , MD 2 , Dongmei Miao , MD 2 , Henry A. Erlich , PHD 3 , George S. Eisenbarth , MD, PHD 2 and Marian Rewers , MD, PHD 1 2 1 Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado 2 Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado 3 Department of Human Genetics, Roche Molecular Systems, Alameda, California Address correspondence and reprint requests to Marian Rewers, MD, PhD, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, 4200 E. 9th Ave., Box B-140, Denver, Colorado 80262. Email: marian.rewers{at}uchsc.edu Abstract 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 = 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 = 0.93, P < 0.001) and IAA ( r 2 = 0.89, P < 0.001) but not IA-2A ( r 2 = 0.05, P = 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. DAISY, Diabetes Autoimmunity Study in the Young GAA, GAD65 autoantibody IA, islet autoimmunity IA-2A, IA-2 autoantibody IAA, insulin autoantibody Footnotes A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted October 30, 2003. Received August 14, 2003. DIABETES CARE