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Åsalinda Lethagen

Physician

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ZnT8 autoantibody titers in type 1 diabetes patients decline rapidly after clinical onset.

Author

  • Fariba Vaziri Sani
  • Shilpa Oak
  • Jared Radtke
  • Åke Lernmark
  • Kristian Lynch
  • Carl-David Agardh
  • Corrado Cilio
  • ÅsaLinda Lethagen
  • Eva Ortqvist
  • Mona Landin-Olsson
  • Carina Törn
  • Christiane S Hampe

Summary, in English

Autoantibodies to the islet-specific zinc transporter isoform 8 (ZnT8) are detected in the majority of type 1 diabetes patients prior to and at clinical diagnosis. The presence of ZnT8Ab after diagnosis has not been investigated. This study analyzed the autoantibody response to ZnT8 in regard to age at onset and disease duration. Two new onset type 1 diabetes patient cohorts with different age distributions at onset (2-17 and 15-34 years of age at onset), a longitudinal subset of the younger type 1 diabetes patient cohort (n = 32), and a cohort of GAD65Ab-positive LADA patients (n = 47) was analyzed for the presence of autoantibodies directed to the two major isoforms, ZnT8-Arginine (ZnT8R) and ZnT8-Tryptophan (ZnT8W). The majority of type 1 diabetes patients tested positive for ZnT8Ab to both isoforms. ZnT8Ab titers were significantly higher in the younger type 1 diabetes patients as compared with the older cohort (ZnT8RAb at a median of 148 and 29 U/ml, respectively, p < 0.001) (ZnT8WAb at a median of 145 and 58 U/ml, respectively, p < 0.01). ZnT8RAb and ZnT8WAb titers were significantly lower in the LADA patients (ZnT8RAb at a median of 14 U/ml, ZnT8WAb at a median of 25 U/ml) as compared with either type 1 diabetes cohorts. In our longitudinal analysis of type 1 diabetes patients after clinical diagnosis, ZnT8Ab levels to both isoforms declined significantly during the initial year of disease (ZnT8RAb from a median of 320-162 U/ml, p = 0.0001; ZnT8WAb from a median of 128-46 U/ml, p = 0.0011). The antibody titers further declined during the following 4 years (p < 0.0001). We conclude that ZnT8Ab presents a useful marker for type 1 diabetes, especially in younger patients at disease diagnosis.

Department/s

  • Diabetes and Celiac Unit
  • Department of Clinical Sciences, Malmö
  • Diabetes - Immunovirology
  • Medicine, Lund
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year

2010

Language

English

Pages

598-606

Publication/Series

Autoimmunity

Volume

Apr 7

Document type

Journal article

Publisher

Taylor & Francis

Topic

  • Rheumatology and Autoimmunity

Status

Published

Research group

  • Diabetes and Celiac Unit
  • Diabetes - Immunovirology

ISBN/ISSN/Other

  • ISSN: 0891-6934