ELEVATED ANTI-BOVINE SERUM ALBUMIN (BSA) ANTIBODIES PREDICT DEVELOPMENT OF TYPE 1 DIABETES IN SIBLINGS OF DIABLTIC CHILDREN

Abstract

Based on our recent observation that IgG-anti-BSA antibodies as determined by a fiuroimmunoassay are highly elevated at diagnosis of Type : diabets in children. we studied the predictive value of these antibodies in 101 ICA and/or IAA-positive and 101 ICA/IAA-negative siblings of children with Type 1 diabetes. The mean age of the siblings was 9.314, 3 and 9.614, 5 years, respectively. The first biood sample was drawn right after diagnosis of diabetes in the proband and every 6 months thereafter. Altogether 4.4 samples were collected/person over a mean observation period of 47 months (range 0.5-70 months). BSA antibody level exceeding the 90th percentile in continuously ICA-negative siblings was considered as elevated.

Results: Elevated anti-BSA antibodies were detected in 46 siblings in the very initial sample and 7 turned positive later on. During the observation period 81 siblings were at least once positive for conventional (IF-ICA) ICA, 58 for complement fixing (CF-ICA) ICA, and 37 for IAA, of whom 46 (56.7%). 27 (46.5%), and 11 (29.7%) were positive for IgG-anti-BSA antibodies. IgG-anti-BSA antibodies were associaed with both types of ICA (p<0.001) but not with IAA. Initial levels of anti-BSA antibodies also correlated with the levels of IF-ICA (r_s=0.37, p<0.001) and CF ICA (r_s=0.44, p<0.001). Nineteen siblings (19/730, 2.6%) have so far presented with diabetes over a mean observation period of 47 months. Of those 90% (N=17) were IF-ICA-positive, 84% (N=16) CF-ICA-positive, and 84% (N=16) IgG-anti-BSA antibody positive in their initial sample compared to 1.7%, 2.1%, and 1.9% of the siblings remaining non-affected (p<0.001). Only 3 (15%) IAA-positive siblings developed diabetes. During the prediabetic phase out of those 3 cases remaining continuously IgG-anti-BSA antibody negative, 1 was negative for all antibodies and 2 were positive for both ICA. One ICA-negative child had elevated IgG-anti-BSA during the prediabetic period.

Conclusion: The results suggest that anti BSA antibodies are predictive for diabetes almost equally to ICA in high risk siblings and are consitent with the hypothesis of BSA as a trigger of the disease.

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