General population screening of T1D in children using electrochemiluminescence (ECL) multiplex assay

This abstract has open access
Abstract Summary

The Autoimmunity Screening for Kids (ASK) program is design to determine the prevalence of pre-symptomatic type 1 diabetes (T1D) and celiac disease (CD) in Denver general population children 1-17 y old. In the initial 16 months, 8120 children were screened for GADA, IA-2A, mIAA as well as for transglutaminase autoantibody (TGA) using both standard radio-binding assay (RBA) and a multiplex electrochemiluminescence (ECL) assay; ZnT8A was measured by RBA only. Positive children are re-tested 2-6 weeks later. At the initial screening, 3.41% (277/8120) of children were positive for at least one islet autoantibody (iAb) by RBA and an additional 26 children (0.32%) were positive for iAb by ECL only. Multiple iAb at screening or confirmation were present in 0.79% of non-Hispanic whites (NHW) and in 0.33% of the other children. ECL assay was congruent with RBA in 91% and identified three additional multiple iAb cases. A single iAb was detected by both RBA and ECL in 0.63% of NHW and 0.55% of the other children. Of the 236 children with a single RBA iAb, 79% were not confirmed by ECL assay. These RBA iAbs were usually at lower levels and have been previously shown to be of low-affinity and not predictive of progression to multiple iAb and T1D ASK is following all iAb positive children to prevent DKA at diagnosis and enroll those eligible into prevention trials. In conclusion, ASK indicates that 85% of the general population children found to be iAb positive by the current ‘gold standard’ RBAs express a single iAb and 79% of those are not at increased risk for T1D. There are ethnic differences in the prevalence of pre-symptomatic stage 1 T1D. Future general population screening programs should consider a two-step approach with highly sensitive initial screening followed by conformation focused on multiplex or single high-affinity autoantibodies.

Submission ID :
IDS51236
Submission Type
Abstract Topics
Barbara Davis Center
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA
Barbara Davis Center for Diabetes, University of Colorado School of Medicine
Barbara Davis Center for Childhood Diabetes
Barbara Davis Center

Abstracts With Same Type

Submission ID
Submission Title
Submission Topic
Submission Type
Primary Author
5 visits

KEY DATES

Event dates:
Thursday 25 October - Monday 29 October 2018

Abstract submission deadline:
Monday 14 May 2018

Abstract notification:
July 2018

Early registration deadline:
Monday 3 September 2018

Registration deadline:
Monday 15 October 2018

Contact
British Society for Immunology
+44 (0)20 3019 5901
congress@immunology.org