On the appearance of islet associated autoimmunity in offspring of diabetic mothers: a prospective study from birth.
For the first time the incidence of insulin autoantibodies and islet cell antibodies were evaluated in a prospective study from birth. Consecutive neonates (168) from mothers with Type 1 (insulin-dependent) diabetes mellitus (n = 113) and gestational diabetes (n = 55) were included at birth. To date, follow-up sera were obtained from 90 of 168 mother-child-pairs 9 months postpartum and from 39 of 168, 2 years postpartum. At birth, there was a strong correlation between the presence of antibodies in the cord blood of neonates and in maternal circulation [Type 1 diabetic mothers: 20% islet cell antibodies > or = 20 JDF-U (detection threshold of our islet cell antibody assay), 74% insulin antibodies > 49 nU/ml (upper limit of normal range in sera of healthy control subjects aged 0.5 to 46 years); neonates: 21% islet cell antibodies > or = 20 JDF-U, 76% insulin antibodies > 49 nU/ml; gestational diabetic mothers: 11% islet cell antibodies > or = 20 JDF-U, 18% insulin antibodies > 49 nU/ml; neonates: 13% islet cell antibodies > or = 20 JDF-U, 55% insulin antibodies > 49 nU/ml]. This supports transplacental passage of insulin antibodies and islet cell antibodies from diabetic mothers to their offspring. During follow-up, the majority of children lost antibody-positivity after birth. A few offspring, however, exhibited or developed antibodies consistently, whereby insulin autoantibodies preceded islet cell antibodies in each case (antibody-positivity: 9 months: 0% islet cell antibody positive, 3.3% insulin autoantibody positive; 2 years: 2.6% islet cell antibody positive, 7.7% insulin autoantibody positive).(ABSTRACT TRUNCATED AT 250 WORDS)
Ziegler
A G
AG
Diabetes Research Institute, Munich, Germany.
Hillebrand
B
B
Rabl
W
W
Mayrhofer
M
M
Hummel
M
M
Mollenhauer
U
U
Vordemann
J
J
Lenz
A
A
Standl
E
E
D000328:Adult; D000375:Aging / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D001942:Breast Feeding; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology*; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics; D016640:Diabetes, Gestational / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D007328:Insulin / Q000097:blood; D007330:Insulin Antibodies / Q000097:blood*; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D010375:Pedigree; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000276:immunology*; D011446:Prospective Studies; D013997:Time Factors
D001323:Autoantibodies; D007328:Insulin; D007330:Insulin Antibodies; C024211:islet cell antibody