Affiliation:
1. Diabetes Clinical Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA
Abstract
OBJECTIVE
Most individuals with two or more islet autoantibodies progress to clinical type 1 diabetes. However, in some individuals, autoantibodies are subsequently lost. Here, our objectives were to determine the frequency of autoantibody loss (reversion) in multiple-autoantibody–positive individuals and to determine the association between reversion and progression to clinical disease.
RESEARCH DESIGN AND METHODS
We analyzed multiple-autoantibody–positive individuals participating in TrialNet’s Pathway to Prevention Study for reversion and determined the effect of reversion on progression to clinical disease using a Cox regression analysis.
RESULTS
Of 3,284 multiple-autoantibody–positive subjects, reversion occurred in 134 (4.1%) and was associated with reduced incidence of clinical disease. Reversion occurred more frequently with older age, lower autoantibody titers, and fewer positive autoantibodies.
CONCLUSIONS
Although reversion of multiple-autoantibody positivity is rare, when it occurs, the risk of progressing to clinical disease is reduced. This suggests unknown mechanisms promoting immune remission in some individuals.
Funder
JDRF
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
15 articles.
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