胰岛自身抗体在糖尿病精准诊断和预测中的价值及进展

Value and advances of islet autoantibodies in the precision diagnosis and prediction of diabetes

胰岛自身抗体是自身免疫糖尿病的体液免疫标志物,联合多个自身抗体检测不但有助于经典1型糖尿病的诊断和发病风险预测,而且能从初诊2型糖尿病中甄别出成人隐匿性自身免疫糖尿病(LADA),并预测其将来对胰岛素治疗的需要。胰岛自身抗体检测方法目前的"金标准"为放射配体法,采用生物素-链酶亲和素的桥联酶联免疫法,以及MSD电化学发光法具有很好的检测效果。新型胰岛自身抗体的发现、多抗体筛查方法的改进以及胰岛自身抗体的异质性研究等,将为临床上筛查自身免疫糖尿病以及预测胰岛功能的衰竭提供更好的手段。

Islet autoantibodies are humoral immunological markers of autoimmune diabetes. Combined detection of it with multiple autoantibodies not only contributes to the diagnosis and risk prediction of classic type 1 diabetes but helps to identify latent autoimmune diabetes in adult(LADA)from newly diagnosed type 2 diabetes,as well as predict its future need for insulin therapy. At present,the gold standard of islet autoantibody detection is radioligand assay In addition,the bridge ELISA method using biotin-streptavidin and the MSD electrochemiluminescence method have a good detection effect. The discovery of novel islet autoantibodies,the improvement of multi-antibody screening methods and the heterogeneity studies of islet autoantibodies will provide better means for clinical screening autoimmune diabetes and predicting islet failure.