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Predicting type 1 diabetes

‘Predicting type 1 diabetes’ Written by Charlotte Harrison, Science Writer 

A team of international scientists have developed a biomarker panel that can predict whether a person will develop type 1 diabetes (T1D) 6 months before the onset of symptoms. Although the biomarker needs further validation before it can be used in the clinic, the work is a key step forward in identifying people at risk from the autoimmune disorder.  

Protein biomarkers

The researchers analysed blood plasma samples of almost 1,000 children aged 0–6 years who were part of the long-running TEDDY study, which seeks to understand the drivers of T1D.  

The authors conducted their proteomic-based research in two phases. First, they conducted a deep proteomics analysis of pooled samples from a relatively small number of individuals (<200). This part of the study identified 376 proteins that were altered in children who later developed T1D or islet autoimmunity – the precursor of T1D.

Next, the validation phase used targeted proteomics to analyse the identified biomarker candidates in samples from a larger number of patients (990) across several time points. This part of the study validated 83 protein biomarkers, including those involved in antigen presentation, complement and blood clotting, inflammatory signalling and metabolism.

Importantly, the researchers found that these processes were also regulated in human islet cells and β-cell models of T1D; this finding indicates that at least some of the processes occur in the pancreas during T1D development.

Outcome prediction

The researchers then built a machine-learning model based on their data to predict whether or not a person will develop T1D. Overall, the machine-learning analysis showed that islet autoimmunity and T1D in a person aged 6 years could be predicted 6 months before the onset of islet autoimmunity.

The scientists caution that their work is just the beginning of the search to predict who will develop T1D. More work needs to be done to verify the current results and test whether the putative biomarker panel applies to everyone, not just the children from the TEDDY study, who were genetically predisposed to developing T1D.

“At this stage, we’re trying to understand how we might be able to predict diabetes. Ultimately, the goal is to prevent critical insulin-producing cells from dying and to prevent diabetes altogether,” said first author Ernesto Nakayasu in a press release.

Image Credit: Canva