Autoimmune Markers in Diabetes

BACKGROUND: Type 1 diabetes (T1DM) results from cell-mediated autoimmune destruction of the beta cells of the islets of Langerhans. Autoantibodies directed against the islets are useful clinical tools that allow the recognition and confirmation of beta-cell autoimmunity. CONTENT: In this review we define the term islet autoantibody, describe the pathogenesis of autoantibody generation, and explain the uses of islet autoantibodies in clinical medicine and in research studies that concern the interruption or prevention of T1DM. We also discuss the biology of islet autoantibodies and their rates of appearance at the time of onset of T1DM and their appearance before the development of T1DM. SUMMARY: The presence of islet autoantibodies in persons with diabetes confirms an autoimmune etiology. In nondiabetic individuals, islet autoantibodies are strong predictors of the later development of T1DM. (C) 2010 American Association for Clinical Chemistry