Effective assay technologies fit for large-scale population screening of type 1 diabetes

While worldwide prevention efforts for type 1 diabetes (T1D) are underway to abrogate or slow progression to diabetes, mass screening of islet autoantibodies (IAbs) in the general population is urgently needed. IAbs, the most reliable biomarkers, play an essential role in prediction and clinical dia...

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Main Authors: Xiaofan Jia, Liping Yu
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-01-01
Series:Frontiers in Clinical Diabetes and Healthcare
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcdhc.2022.1034698/full
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author Xiaofan Jia
Liping Yu
author_facet Xiaofan Jia
Liping Yu
author_sort Xiaofan Jia
collection DOAJ
description While worldwide prevention efforts for type 1 diabetes (T1D) are underway to abrogate or slow progression to diabetes, mass screening of islet autoantibodies (IAbs) in the general population is urgently needed. IAbs, the most reliable biomarkers, play an essential role in prediction and clinical diagnosis of T1D. Through laboratory proficiency programs and harmonization efforts, a radio-binding assay (RBA) has been well established as the current ‘gold’ standard assay for all four IAbs. However, in view of the need for large-scale screening in the non-diabetic population, RBA consistently faces two fundamental challenges, cost-efficiency and disease specificity. While all four IAbs are important for disease prediction, the RBA platform, with a separate IAb test format is laborious, inefficient and expensive. Furthermore, the majority of IAb positivity in screening, especially from individuals with single IAb were found to be low risk with low affinity. It is well documented from multiple clinical studies that IAbs with low affinity are low risk with less or no disease relevance. At present, two non-radioactive multiplex assays, a 3-assay ELISA combining three IAbs and a multiplex ECL assay combining all four IAbs, have been successfully used as the primary methods for general population screenings in Germany and the US, respectively. Recently, the TrialNet Pathway to Prevention study has been organizing an IAb workshop which aims to analyze the 5-year T1D predictive values of IAbs. A T1D-specific assay with high efficiency, low cost and requiring low volume of sample will definitely be necessary to benefit general population screening.
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spelling doaj.art-08d8278c89ce443e8c83c826ef6948b12023-01-23T06:24:58ZengFrontiers Media S.A.Frontiers in Clinical Diabetes and Healthcare2673-66162023-01-01310.3389/fcdhc.2022.10346981034698Effective assay technologies fit for large-scale population screening of type 1 diabetesXiaofan JiaLiping YuWhile worldwide prevention efforts for type 1 diabetes (T1D) are underway to abrogate or slow progression to diabetes, mass screening of islet autoantibodies (IAbs) in the general population is urgently needed. IAbs, the most reliable biomarkers, play an essential role in prediction and clinical diagnosis of T1D. Through laboratory proficiency programs and harmonization efforts, a radio-binding assay (RBA) has been well established as the current ‘gold’ standard assay for all four IAbs. However, in view of the need for large-scale screening in the non-diabetic population, RBA consistently faces two fundamental challenges, cost-efficiency and disease specificity. While all four IAbs are important for disease prediction, the RBA platform, with a separate IAb test format is laborious, inefficient and expensive. Furthermore, the majority of IAb positivity in screening, especially from individuals with single IAb were found to be low risk with low affinity. It is well documented from multiple clinical studies that IAbs with low affinity are low risk with less or no disease relevance. At present, two non-radioactive multiplex assays, a 3-assay ELISA combining three IAbs and a multiplex ECL assay combining all four IAbs, have been successfully used as the primary methods for general population screenings in Germany and the US, respectively. Recently, the TrialNet Pathway to Prevention study has been organizing an IAb workshop which aims to analyze the 5-year T1D predictive values of IAbs. A T1D-specific assay with high efficiency, low cost and requiring low volume of sample will definitely be necessary to benefit general population screening.https://www.frontiersin.org/articles/10.3389/fcdhc.2022.1034698/fulltype 1 diabetesautoantibodiesscreeningpredictionbiomarkers
spellingShingle Xiaofan Jia
Liping Yu
Effective assay technologies fit for large-scale population screening of type 1 diabetes
Frontiers in Clinical Diabetes and Healthcare
type 1 diabetes
autoantibodies
screening
prediction
biomarkers
title Effective assay technologies fit for large-scale population screening of type 1 diabetes
title_full Effective assay technologies fit for large-scale population screening of type 1 diabetes
title_fullStr Effective assay technologies fit for large-scale population screening of type 1 diabetes
title_full_unstemmed Effective assay technologies fit for large-scale population screening of type 1 diabetes
title_short Effective assay technologies fit for large-scale population screening of type 1 diabetes
title_sort effective assay technologies fit for large scale population screening of type 1 diabetes
topic type 1 diabetes
autoantibodies
screening
prediction
biomarkers
url https://www.frontiersin.org/articles/10.3389/fcdhc.2022.1034698/full
work_keys_str_mv AT xiaofanjia effectiveassaytechnologiesfitforlargescalepopulationscreeningoftype1diabetes
AT lipingyu effectiveassaytechnologiesfitforlargescalepopulationscreeningoftype1diabetes