Development of two alternative enzyme-linked immunosorbent assays for routine screening of glutamic acid decarboxylase autoantibodies

VILLALBA A., VALDEZ S.N., IACONO R.F., POSKUS E.

CLINICA CHIMICA ACTA

Elsevier

Año: 2007 vol. 376 p. 82 - 87

0009-8981

Background: Antibodies to GAD65 (GADA) are considered highly predictive humoral markers of the type 1 diabetes mellitus and also of the insulin requirement in adult-onset patients presumptively classified as type 2 diabetics or LADA. Methods: We present two methods for GADA assessment. The first one (fluid phase, ELISA protocol A) is carried out in a two step procedure in which serum GADA are first allowed to react with a fixed dose of GAD65‑biotin in solution and the residual free antigen, is later assayed by a conventional ELISA. In the second test (solid phase, ELISA protocol B) GADA are measured in an ELISA that depends on the ability of divalent autoantibodies to form a bridge between immobilized TrxGAD65 and liquid-phase biotinylated TrxGAD65. Results: All normal control samples scored negative in both variants of ELISA and RBA, hence specificity was 100 % for all methods; the relative sensitivity of ELISA Protocol A respect of the RBA was 94% and that of ELISA Protocol B was 76%. Conclusions: Although ELISA Protocol A exhibited a better performance in terms of relative sensitivity than ELISA Protocol B, the simplicity of execution and the intended use of the assay must also be taken in consideration for the final choice.