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Autoantibody-Negative Type 1 Diabetes: A Neglected Subtype.

Shivani K Patel1, Cindy S Ma2, Spiros Fourlanos3

  • 1Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, NSW, Australia; Department of Diabetes and Endocrinology, St. Vincent's Hospital, Sydney, NSW, Australia; St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.

Trends in Endocrinology and Metabolism: TEM
|March 13, 2021
PubMed
Summary

A subset of type 1 diabetes (T1D) patients lack autoantibodies, remaining understudied. Understanding autoantibody-negative T1D is crucial for improved diagnostics and precision medicine therapies.

Keywords:
autoantibody-negativeautoimmune diabetescharacterisationimmunophenotypetype 1 diabetes

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Area of Science:

  • Endocrinology
  • Immunology
  • Metabolic Diseases

Background:

  • Type 1 diabetes (T1D) diagnosis typically relies on autoantibody presence.
  • A significant percentage of T1D cases (up to 15%) are autoantibody-negative, often termed idiopathic or nonimmune T1D.
  • This autoantibody-negative T1D group is understudied and excluded from immunomodulatory clinical trials.

Purpose of the Study:

  • To review the current understanding of autoantibody-negative T1D.
  • To highlight the challenges in studying this specific T1D population.
  • To explore potential distinctions in aetiopathogenesis between autoantibody-positive and -negative T1D.

Main Methods:

  • Literature review of T1D classification criteria.
  • Analysis of existing research on autoimmunity in T1D.
  • Examination of immunogenic pathway defects potentially differentiating T1D phenotypes.

Main Results:

  • Autoantibody-negative T1D represents a distinct clinical entity.
  • Limited understanding of its pathogenesis impedes diagnostic and therapeutic advancements.
  • Further research is needed to elucidate the underlying mechanisms.

Conclusions:

  • Autoantibody-negative T1D requires dedicated research focus.
  • Clarifying its aetiopathogenesis is essential for personalized medicine approaches in T1D.
  • Improved diagnostic strategies and targeted therapies may emerge from studying this cohort.