DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. GottliebT1D Autoantibodies: room for improvement?Yu, Liping; Zhao, Zhiyuan; Steck, Andrea K.Author Information Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA Correspondence to Liping Yu, MD, Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, 1775 Aurora Ct, B140, M20-4201C, Aurora, CO 80045, USA. Tel: +1 303 724 6808; fax: +1 303 724 5811; e-mail: [email protected] Current Opinion in Endocrinology & Diabetes and Obesity: August 2017 - Volume 24 - Issue 4 - p 285-291 doi: 10.1097/MED.0000000000000348 Buy Metrics Abstract Purpose of review Type 1 diabetes (T1D) is now predictable by measuring major islet autoantibodies (IAbs) against insulin and other pancreatic β cells proteins including GAD65 (GADA), islet antigen 2 (IA-2A), and zinc transporter 8 (ZnT8A). The assay technology for IAbs has made great progress; however, several important aspects still need to be addressed and improved. Recent findings Currently a radio-binding assay has been well established as the ‘gold’ standard assay for all four IAbs. New generation of nonradioactive IAb assay with electrochemiluminescence technology has been shown to further improve sensitivity and disease specificity. Recently, multiplexed assays have opened the possibility of more efficient screening in large populations. Identification of potential new autoantibodies to neo-antigens or neo-epitopes posttranslational modification is a new important field to be explored. Summary Individuals having a single positive autoantibody are at low risk for progression to T1D, whereas individuals expressing two or more positive autoantibodies, especially on multiple tests over time, have nearly 100% risk of developing clinical T1D when followed for over two decades. More efficient and cost effective IAb assays will hopefully lead to point-of-care screening in the general population. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.