Besides ICA, other islet autoantibodies can be detected in LADA subjects such as GADA and ZnT8A.
Of the five islet autoantibodies discussed in this article, IAA are the least common autoantibodies at disease onset.
The newest islet autoantibodies entering the realm of routine clinical usefulness are directed against transporter-8 that moves zinc from the cytoplasm to the insulin-containing secretory granules.
If a single islet autoantibody or multiple islet autoantibodies are detected, the diagnosis of an autoimmune form of diabetes is confirmed.
Once type I diabetes can be prevented, the case can be made that all children should be screened for islet autoantibodies on multiple occasions to identify those children at highest risk for developing type I diabetes.
Recently, the appearance of islet autoantibodies has been described in older children who many years earlier had developed neonatal diabetes from KCNJ11 gene mutations (12).
If the immune system is not tolerant to the self antigen, because the self antigen is normally sequestered, the immunizing event resulting from the infection or some other environmental exposure leads to cross-reactive immunity to the self antigen with the appearance of islet autoantibodies (assuming that the immunoassay system is using an islet autoantigen as its target).
The list of islet autoantibodies and autoantigens to which islet autoantibodies have been detected is expansive (Table 1) (14-34).
Thus, over time, more islet autoantibodies appear and epitope spreading occurs (37).
0302 general-population children, we can now identify a risk of 20% of activating islet autoantibodies by excluding both [DP.
Children who have a family history of T1D and the HLA risk genotypes DR3/4-DQ8 or DR4/DR4 have a more than 1 in 5 risk for developing islet autoantibodies during childhood (71, 74) and approximately a 1 in 20 risk without a relative with T1D (74).
Children will be monitored for the development of islet autoantibodies, diabetes, and protective immune responses to insulin.