title: Antibodies against bovine albumin and other diabetes markers in French children.
abstract: OBJECTIVE
  Findings in epidemiology and animal experimentation suggest that autoimmunity in insulin-dependent diabetes mellitus (IDDM) may be triggered by dietary cow-milk protein, particularly bovine serum albumin (BSA). Elevated IgG anti-BSA antibodies were found in children from Finland with newly onset diabetes; Finland has the highest incidence of diabetes and cow's milk consumption in the world. We now analyze BSA serology and other diabetes markers in school-age children from France, where diabetes incidence and cow's milk consumption are low.
  
  
  METHODS
  Sera were obtained from three groups: newly diagnosed diabetic (n = 43), islet cell antibody-positive (ICA+) nondiabetic (n = 98), and ICA- healthy control children (n = 267). IgG anti-BSA antibody levels were measured blindly using particle concentration fluoroimmunoassays and analyzed in comparison with ICA titers and human leukocyte antigen-DQB genotypes.
  
  
  RESULTS
  There were highly significant differences in BSA antibody levels between all three groups (P < 0.0001). Diabetic patients had elevated anti-BSA levels in 74.4% of cases, compared with 5.5% of control children. In the group of ICA+ non-diabetic children, 20% were anti-BSA-positive. Neither ICA nor BSA antibody titers were significantly related to DQB genotype or sex. ICA titers ( > or = 4 Juvenile Diabetes Foundation units) were present in 84% of diabetic children. Two-thirds of diabetic children were positive for both ICA and anti-BSA antibodies, and none were negative for both markers.
  
  
  CONCLUSIONS
  Elevated IgG anti-BSA levels are associated with IDDM in the low-incidence French population. In newly diagnosed diabetic children, these antibodies have similar specificity (95 vs. 98%) and slightly lower sensitivity for IDDM than ICA (74.4 vs. 83.7%). Our results may support an immunological role of BSA in diabetic autoimmunity.
authors.affiliation: INSERM CJF 93-13, Hôpital Robert Debré, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Lévy-Marchal
authors.forename: J
authors.initials: J
authors.lastname: Karjalainen
authors.forename: F
authors.initials: F
authors.lastname: Dubois
authors.forename: W
authors.initials: W
authors.lastname: Karges
authors.forename: P
authors.initials: P
authors.lastname: Czernichow
authors.forename: H M
authors.initials: HM
authors.lastname: Dosch
mesh_terms: D000293:Adolescent; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology*; D005260:Female; D005602:France; D006683:HLA-DQ Antigens / Q000097:blood; D059866:HLA-DQ beta-Chains; D006650:Histocompatibility Testing; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007223:Infant; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D012016:Reference Values; D012710:Serum Albumin, Bovine / Q000276:immunology*; D012727:Sex Characteristics
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D007074:Immunoglobulin G; C024211:islet cell antibody; D012710:Serum Albumin, Bovine