How does antibody combination really predict IDDM in the general population? Fortune telling—not fortune spending
✍ Scribed by Pinhas-Hamiel, Orit ;Sprecher, Elliot ;Vardi, Pnina
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 113 KB
- Volume
- 14
- Category
- Article
- ISSN
- 0742-4221
No coin nor oath required. For personal study only.
✦ Synopsis
Autoimmune destruction of pancreatic cells in insulin-dependent diabetic patients often begins months, even years, prior to clinical onset of the disease. It is for this reason that intervention trials aimed to prevent insulin-dependent diabetes mellitus (IDDM) are offered to IDDM patients' first-degree relatives, where the detectable presence of circulating autoantibodies indicates the preclinical phase of the disease. 1 Nevertheless, relatives of IDDM patients constitute only about 10% of the newly diagnosed diabetic patients overall, while the remaining 90% are sporadic cases, with no hint that they are at any risk. Thus, to date, only a minority of future diabetic patients can benefit from a preventive approach, indicating that attempts to predict the disease should be redirected toward the general population. Indeed, several investigators have initiated studies employing different combinations of immune, genetic and metabolic markers 2 in efforts to predict IDDM among the general population. Given the relatively low disease prevalence among the general population compared to IDDM first-degree relatives, and the high cost of the present available tools, a low cost-benefit is expected. 3,4 Prediction of future IDDM is now feasible with various serological markers, mainly autoantibodies to the islet cell (ICAs), to insulin (IAA), to glutamic acid decarboxylase (GAD), and to tyrosine phosphatase (ICA-512), employed individually or in combination. In