Is presence of islet autoantibodies at birth associated with development of persistent islet autoimmunity? The Diabetes Autoimmunity Study in the Young (DAISY).
OBJECTIVE
To determine whether the presence of islet autoantibodies in the umbilical cord blood is predictive of subsequent development of islet autoimmunity.


METHODS
Cord blood sera from 1,118 subjects from the Diabetes Autoimmunity Study in the Young (DAISY) cohort, as well as their venous blood samples taken at follow-up clinic visits, were tested for GAD65 autoantibodies (GAAs), insulin autoantibodies (IAAs), and IA-2 autoantibodies (IA-2As). Venous blood samples taken from mothers of cord blood autoantibody-positive children were analyzed for the same autoantibodies.


RESULTS
At least one of three islet autoantibodies was present in 42 (3.7%) of the cord blood samples tested. The presence of cord blood autoantibodies did not predict the subsequent development of islet autoimmunity (adjusted hazard ratio = 0.73 [0.09, 5.88]). Discordance between cord blood and corresponding maternal autoantibodies was seen in 3 of 36 infants. A strong correlation between levels of autoantibody in cord blood and maternal circulation was found for GAA (r(2) = 0.93, P < 0.001) and IAA (r(2) = 0.89, P < 0.001) but not IA-2A (r(2) = 0.05, P = 0.19). Cord blood autoantibodies in all but one subject disappeared by 9 months of age.


CONCLUSIONS
The presence of cord blood autoantibodies is not predictive of subsequent development of islet autoimmunity. The majority of cord blood autoantibodies appear to result from maternal transmission.
Stanley
Heather M
HM
Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
Norris
Jill M
JM
Barriga
Katherine
K
Hoffman
Michelle
M
Yu
Liping
L
Miao
Dongmei
D
Erlich
Henry A
HA
Eisenbarth
George S
GS
Rewers
Marian
M
D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity / Q000502:physiology*; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000276:immunology*; D005500:Follow-Up Studies; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D007515:Islets of Langerhans / Q000276:immunology; D007527:Isoenzymes / Q000276:immunology; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors
D001323:Autoantibodies; D007527:Isoenzymes; C024211:islet cell antibody; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2