< Terug naar vorige pagina


Combined analysis of GAD65, miR-375, and unmethylated insulin DNA following islet transplantation in patients with T1D

Tijdschriftbijdrage - Tijdschriftartikel

Aim Several biomarkers have been proposed to detect pancreatic β cell destruction in vivo but so far have not been compared for sensitivity and significance. Methods We used islet transplantation as a model to compare plasma concentrations of miR-375, 65-kDa subunit of glutamate decarboxylase (GAD65), and unmethylated insulin DNA, measured at subpicomolar sensitivity, and study their discharge kinetics, power for outcome prediction, and detection of graft loss during follow-up. Results At 60 minutes after transplantation, GAD65 and miR-375 consistently showed near-equimolar and correlated increases proportional to the number of implanted β cells. GAD65 and miR-375 showed comparable power to predict poor graft outcome at 2 months, with areas under the curve of 0.833 and 0.771, respectively (P = 0.53). Using receiver operating characteristic analysis, we defined likelihood ratios (LRs) for rationally selected result intervals. In GADA-negative recipients (n = 28), GAD65 <4.5 pmol/L (LR = 0.15) and >12.2 pmol/L (LR = z) predicted good and poor outcomes, respectively. miR-375 could be used in all recipients irrespective of GAD65 autoantibody status (n = 46), with levels <1.4 pmol/L (LR = 0.14) or >7.6 pmol/L (LR = 9.53) as dual thresholds. The posttransplant surge of unmethylated insulin DNA was inconsistent and unrelated to outcome. Combined measurement of these three biomarkers was also tested as liquid biopsy for β cell death during 2-month follow-up; incidental surges of GAD65, miR-375, and (un)methylated insulin DNA, alone or combined, were confidently detected but could not be related to outcome. Conclusions GAD65 and miR-375 performed equally well in quantifying early graft destruction and predicting graft outcome, outperforming unmethylated insulin DNA.

Tijdschrift: J Clin Endocrinol Metab
Issue: 2
Volume: 104
Pagina's: 451-460
Jaar van publicatie:2019
  • ORCID: /0000-0003-4445-308X/work/156351558
  • Scopus Id: 85059271055
  • DOI: https://doi.org/10.1210/jc.2017-02520
  • WoS Id: 000462864100029
  • ORCID: /0000-0003-3148-1372/work/58880600
  • ORCID: /0000-0002-9007-6177/work/60767577
  • ORCID: /0000-0002-0190-5819/work/61225490
  • ORCID: /0000-0002-8671-4527/work/61349411
  • ORCID: /0000-0002-6440-2485/work/61423527
  • ORCID: /0000-0003-1208-6289/work/64112729
  • Institutional Repository URL: https://cris.vub.be/ws/files/49675304/jc.2017_02520.pdf
  • PubMed Central Id: PMC6310912
CSS-citation score:2