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Cortez FDJ, Gebhart D, Robinson PV, Seftel D, Pourmandi N, Owyoung J, Bertozzi CR, Wilson DM, Maahs DM, Buckingham BA, Mills JR, Roforth MM, Pittock SJ, McKeon A, Page K, Wolf WA, Sanda S, Speake C, Greenbaum CJ, Tsai CT. Sensitive detection of multiple islet autoantibodies in type 1 diabetes using small sample volumes by agglutination-PCR. PLoS One 2020; 15:e0242049. [PMID: 33186361 PMCID: PMC7665791 DOI: 10.1371/journal.pone.0242049] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
Islet autoantibodies are predominantly measured by radioassay to facilitate risk assessment and diagnosis of type 1 diabetes. However, the reliance on radioactive components, large sample volumes and limited throughput renders radioassay testing costly and challenging. We developed a multiplex analysis platform based on antibody detection by agglutination-PCR (ADAP) for the sample-sparing measurement of GAD, IA-2 and insulin autoantibodies/antibodies in 1 μL serum. The assay was developed and validated in 7 distinct cohorts (n = 858) with the majority of the cohorts blinded prior to analysis. Measurements from the ADAP assay were compared to radioassay to determine correlation, concordance, agreement, clinical sensitivity and specificity. The average overall agreement between ADAP and radioassay was above 91%. The average clinical sensitivity and specificity were 96% and 97%. In the IASP 2018 workshop, ADAP achieved the highest sensitivity of all assays tested at 95% specificity (AS95) rating for GAD and IA-2 autoantibodies and top-tier performance for insulin autoantibodies. Furthermore, ADAP correctly identified 95% high-risk individuals with two or more autoantibodies by radioassay amongst 39 relatives of T1D patients tested. In conclusion, the new ADAP assay can reliably detect the three cardinal islet autoantibodies/antibodies in 1μL serum with high sensitivity. This novel assay may improve pediatric testing compliance and facilitate easier community-wide screening for islet autoantibodies.
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Affiliation(s)
| | - David Gebhart
- Enable Biosciences Inc., South San Francisco, CA, United States of America
| | - Peter V. Robinson
- Enable Biosciences Inc., South San Francisco, CA, United States of America
| | - David Seftel
- Enable Biosciences Inc., South San Francisco, CA, United States of America
| | - Narges Pourmandi
- Enable Biosciences Inc., South San Francisco, CA, United States of America
| | - Jordan Owyoung
- Enable Biosciences Inc., South San Francisco, CA, United States of America
| | - Carolyn R. Bertozzi
- Department of Chemistry, Stanford University, Stanford, CA, United States of America
- Stanford Diabetes Research Center, Stanford, CA, United States of America
| | - Darrell M. Wilson
- Stanford Diabetes Research Center, Stanford, CA, United States of America
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - David M. Maahs
- Stanford Diabetes Research Center, Stanford, CA, United States of America
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Bruce A. Buckingham
- Stanford Diabetes Research Center, Stanford, CA, United States of America
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - John R. Mills
- Department of Laboratory Medicine/Pathology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
- Department of Neurology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
| | - Matthew M. Roforth
- Department of Laboratory Medicine/Pathology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
- Department of Neurology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
| | - Sean J. Pittock
- Department of Laboratory Medicine/Pathology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
- Department of Neurology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
| | - Andrew McKeon
- Department of Laboratory Medicine/Pathology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
- Department of Neurology, Mayo Clinic, College of Medicine, Rochester, MN, United States of America
| | - Kara Page
- T1D Exchange, Boston, MA, United States of America
| | | | - Srinath Sanda
- Diabetes Center, University of California, San Francisco, San Francisco, CA, United States of America
| | - Cate Speake
- Diabetes Clinical Research Program, Benaroya Research Institute, Seattle, WA, United States of America
| | - Carla J. Greenbaum
- Diabetes Clinical Research Program, Benaroya Research Institute, Seattle, WA, United States of America
| | - Cheng-ting Tsai
- Enable Biosciences Inc., South San Francisco, CA, United States of America
- * E-mail:
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