[Glutamate decarboxylase (GAD)--an autoantigen in insulin-dependent diabetes mellitus (IDDM)]

Abstract

The number of antibodies to pancreatic beta-cell antigens in IDDM increased in the last years, involving antibodies to glutamic acid decarboxylase (GADab). A short review is given about the diagnostic and prognostic value of GADab determination in IDDM. The GAD plays an important, possibly a key role in the initial immunological events leading to the destruction of beta cells. The question is open whether the immunological reaction against GAD is a primary one, or if it is a result of mimicry of a part of an infectious protein antigen (Coxackie virus). The immunological reaction to GAD is associated with both humoral and cellular responses. The cellular response seems to be more important than the humoral one. The cellular response may be mediated through the HLA complex class I cells (cytotoxic lymphocytes) and the HLA complex class II cells (helper lymphocytes). There are arguments for both possibilities. The principles of GADab determination are shortly described. (Ref. 34.)