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J Diabetes Investig. 2019 Mar 27. doi: 10.1111/jdi.13052. [Epub ahead of print]

Circulating anti-glutamic acid decarboxylase-65 antibody titers are positively associated with the capacity of insulin secretion in acute-onset type 1 diabetes with short duration in a Japanese population.

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Division of Diabetes, Department of Medicine, Metabolism and Endocrinology, Showa University School of Medicine, Tokyo, Japan.
Gaienhigashi Clinic, Tokyo, Japan.
Division of Immunology and Molecular Medicine, Okinaka Memorial Institute for Medical Research, Tokyo, Japan.



To elucidate the relationship between titers of islet autoantibodies, the C-X-C motif chemokine 10 - a circulating chemokine that activates T-helper 1 cells leading to β-cell destruction - and β-cell function in type 1 diabetes.


In total, 58 type 1 diabetes patients positive for glutamic decarboxylase-65 autoantibodies (GADA)-radioimmunoassay (mean age 54.1 years; 27 acute-onset cases and 31 slowly progressive cases) were enrolled; serum C-X-C motif chemokine 10 (n = 50), zinc transporter 8 autoantibodies (n = 50) and GADA (n = 58) by an enzyme-linked immunosorbent assay, and insulinoma-associated antigen-2 autoantibodies by radioimmunoassay (n = 50) were measured. The ratio of 100 × random C-peptide (ng/mL)-to-plasma glucose levels (mg/dL; C-peptide index [CPI]) was measured.


The CPI significantly decreased in both groups with the progression of disease duration. GADA titers by radioimmunoassay and enzyme-linked immunosorbent assay were strongly correlated with the CPI in acute-onset type 1 diabetes patients with a shorter disease duration (≤10 years), but not in those with a longer duration or slowly progressive type 1 diabetes. Neither insulinoma-associated antigen-2 nor zinc transporter 8 autoantibodies titers were correlated with the CPI. Serum C-X-C motif chemokine 10 levels in both groups were significantly higher than in non-diabetic controls, and persisted at high levels even in those with chronic duration.


Among islet autoantibodies, the intensity of the humoral immune response, as defined by GADA titers, reflected the degree of residual β-cell function in acute-onset type 1 diabetes patients with short duration. Prolonged disease activity might accelerate β-cell impairment in both subtypes of type 1 diabetes.


C-X-C motif chemokine 10; Glutamic decarboxylase-65; Type 1 diabetes

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