Evaluation of the efficacy of the combination of multiple autoantibodies to islet-specific antigens in Korean type 1 diabetic patients

With the recent cloning and recombinant expression of novel islet autoantig ens, it is possible to investigate whether the quantitative expression of a utoantibodies to those molecules is correlated with the semiquantitative ti tration of islet cell antibodies (ICA). To estimate the regional difference in the degree of association between these autoantibodies, autoantibodies reacting with ICA512/IA-2 (ICA512) and GAD65 in addition to ICA were analyz ed in 131 Korean children with type I diabetes. Among the 131 type 1 diabet es patients, 36% was ICA512-positive, 56% was anti-GAD65-positive, and 43% was ICA-positive. However, in a subset of these with recent onset (<1 year) , the prevalences of ICA512, anti-GAD65, and ICA were 75%, 75%, and 87.5%, respectively. ICA512 as well as anti-GAD65 were significantly associated wi th the presence of ICA. Among type 1 diabetes patients, 69% had one or more and 43% had two or more of these autoantibodies. Autoantibodies to ICA512 and anti-GAD65 were observed in 40 and in 41 of 56 TCA-positive subjects, r espectively. Furthermore, ICA512 or anti-GAD65 were positive in 97% (34 of 35) and 100% (22 of 22) of patients with ICA levels <greater than or equal to>20 JDF-u and greater than or equal to 40 JDF-u, respectively. The titer of ICA correlated with those of ICA512 (r=0.41, p<0.001) and anti-GAD65 (r= 0.49, p<0.001). Both the prevalences and the titers of ICA512 or anti-GAD65 were strongly con-elated with those of ICA even in Korean type 1 diabetes patients. ICA512 and anti-GAD65 in combination may be considered to be an a lternative to ICA.