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Diabetes Care. 2020 Apr;43(4):913-917. doi: 10.2337/dc19-1731. Epub 2020 Feb 4.

Autoantibody Reversion: Changing Risk Categories in Multiple-Autoantibody-Positive Individuals.

Author information

1
Diabetes Clinical Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA.
2
Diabetes Clinical Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA cspeake@benaroyaresearch.org.

Abstract

OBJECTIVE:

Most individuals with two or more islet autoantibodies progress to clinical type 1 diabetes. However, in some individuals, autoantibodies are subsequently lost. Here, our objectives were to determine the frequency of autoantibody loss (reversion) in multiple-autoantibody-positive individuals and to determine the association between reversion and progression to clinical disease.

RESEARCH DESIGN AND METHODS:

We analyzed multiple-autoantibody-positive individuals participating in TrialNet's Pathway to Prevention Study for reversion and determined the effect of reversion on progression to clinical disease using a Cox regression analysis.

RESULTS:

Of 3,284 multiple-autoantibody-positive subjects, reversion occurred in 134 (4.1%) and was associated with reduced incidence of clinical disease. Reversion occurred more frequently with older age, lower autoantibody titers, and fewer positive autoantibodies.

CONCLUSIONS:

Although reversion of multiple-autoantibody positivity is rare, when it occurs, the risk of progressing to clinical disease is reduced. This suggests unknown mechanisms promoting immune remission in some individuals.

PMID:
32019856
PMCID:
PMC7085807
[Available on 2021-04-01]
DOI:
10.2337/dc19-1731

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