The early detection of type 1 diabetes mellitus and latent autoimmune diabetes in adults (LADA) through rapid test reverse-flow immunochromatography for glutamic acid decarboxylase 65 kDa (GAD65)

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Aulanni'am Aulanni'am, Dyah Kinasih Wuragil, Hendra Susanto, Anita Herawati, Yulianto Muji Nugroho, Wahyu Nur Laili Fajri, Perdana Finawati Putri, Susiati Susiati, Jerry Dwi Trijoyo Purnomo, Ahmad Taufiq, Djoko Wahono Soeatmadji

2022 Heliyon Vol. 8 Issue 1 Article Cited by 7 Quartile

Abstract

Background: Diabetes mellitus (DM) is a chronic and costly disease that has become a primary concern worldwide. Type 1 diabetes mellitus is categorized as an autoimmune disease, which results in islet cell apoptosis and insulin-dependent. GAD65 is known as a potential marker of impaired pancreatic β cell function that appears in the initial phase of type 1 DM and latent autoimmune diabetes in adults (LADA). This study aimed to develop a novel rapid test of anti-GAD65 autoantibodies in human serum samples. Methods: We have developed a rapid test for anti-GAD65 autoantibodies in this assay based on the reverse-flow immunochromatography method. Human recombinant-protein antigen for GAD65 was attached as the control line over the nitrocellulose membrane. On the other side, the goat anti-mouse immunoglobulin G (IgG) was coated on the same membrane as a control line. The positive result for GAD65 was confirmed by a colloidal gold signal on the strip. Our novel assay analyzed 276 healthy subjects and 51 type 1 diabetes individuals serum samples from several ethnicities in Indonesia for this study. Results: Among the 276 healthy samples, 225 samples were identified as positive for anti-GAD65 autoantibodies, while 51 samples were negative. Interestingly, the positive results for anti-GAD65 autoantibodies were linear to the decreasing of high-density lipoprotein (HDL) levels and inversely associated with triglyceride levels. A significant correlation with age was observed in all groups. The sensitivity and specificity test proved that this kit has higher accuracy (AUC value = 0.960). Conclusion: The significant advantages of our rapid test for anti-GAD65 autoantibodies provide higher sensitivity, specificity, and stability compared to previous commercial kits. Therefore, it could be proposed as the future clinical diagnostic kit for patient management of type 1 DM. © 2021 The Authors

Affiliations

Faculty of Sciences, Brawijaya University, Indonesia; Faculty of Veterinary Medicine, Brawijaya University, Indonesia; Biosains Institute, Brawijaya University, Indonesia; Faculty of Mathematics and Natural Sciences, Universitas Negeri Malang, Indonesia; Faculty of Medicine, Brawijaya University, Indonesia; Faculty of Science and Data Analytics, Institut Teknologi Sepuluh November, Indonesia