Improved diagnosis of type-1 diabetes mellitus using multiplexed autoantibodies ELISA array

Autoantibodies are currently the most robust biomarkers of type 1 diabetes. However, single autoantibody targeted detection is still limited in diabetes diagnosis with poor performance. Here, we develop a multiplexed Array-ELISA assay that can detect five diabetes-related autoantibodies including glutamic acid decarboxylase antibody (GADA), insulinoma antigen 2 antibody (IA-2A), islet cell antibody (ICA), zinc transporter 8 autoantibody (ZnT8-A) and insulin antibody (IAA) simultaneously. This assay achieved 100% accuracy in identifying the positive and negative control samples with good repeatability (CV<15%). We applied the Array-ELISA assay to 140 clinical serum samples of healthy subjects and diabetes patients and the assay showed improved diagnosis accuracy (sensitivity of 62.5%, specificity of 94.3%) compared with the single target immunoblotting test. These data suggest that the Array-ELISA assay can provide diagnostic and predictive ability in the clinical practice of type 1 diabetes.