General population screening for type 1 diabetes using islet autoantibodies at the preschool vaccination visit: a proof-of-concept study (the T1Early study).

Autor:	Scudder C; JDRF/Wellcome Diabetes and Inflammation Laboratory, Centre for Human Genetics, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK., Townson J; Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK., Bowen-Morris J; Cardiff University School of Medicine, Cardiff University, Cardiff, UK., Gillespie K; Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK., Evans P; Exeter Collaboration for Academic Primary Care (APEx), University of Exeter, Exeter, UK., Jones S; Windrush Medical Practice, Witney, UK., Thomas NPB; Windrush Medical Practice, Witney, UK., Stanford J; Bicester Health Centre, Bicester, UK., Fox R; Bicester Health Centre, Bicester, UK., Todd JA; JDRF/Wellcome Diabetes and Inflammation Laboratory, Centre for Human Genetics, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK., Greenfield S; Institute of Applied Health Research, College of Medical and Dental Sciences, Murray Learning Centre, University of Birmingham, Birmingham, UK., Dayan CM; JDRF/Wellcome Diabetes and Inflammation Laboratory, Centre for Human Genetics, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.; Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK., Besser REJ; JDRF/Wellcome Diabetes and Inflammation Laboratory, Centre for Human Genetics, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK rachel.besser@paediatrics.ox.ac.uk.; Department of Paediatrics, University of Oxford, Oxford, UK.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2024 Sep 25; Vol. 109 (10), pp. 812-817. Date of Electronic Publication: 2024 Sep 25.
DOI:	10.1136/archdischild-2023-326697
Abstrakt:	Objective: Type 1 diabetes (T1D) screening programmes testing islet autoantibodies (IAbs) in childhood can reduce life-threatening diabetic ketoacidosis. General population screening is required to detect the majority of children with T1D, since in >85% there is no family history. Age 3-5 years has been proposed as an optimal age for a single screen approach. Design: Capillary samples were collected from children attending their preschool vaccination and analysed for IAbs to insulin, glutamic acid decarboxylase, islet antigen-2 and zinc transporter 8 using radiobinding/luciferase immunoprecipitation system assays. Acceptability was assessed using semistructured interviews and open-ended postcard questionnaires with parents. Setting: Two primary care practices in Oxfordshire, UK. Main Outcome Measures: The ability to collect capillary blood to test IAbs in children at the routine preschool vaccination (3.5-4 years). Results: Of 134 parents invited, 66 (49%) were recruited (median age 3.5 years (IQR 3.4-3.6), 26 (39.4%) male); 63 provided a sample (97% successfully), and one participant was identified with a single positive IAb. Parents (n=15 interviews, n=29 postcards) were uniformly positive about screening aligned to vaccination and stated they would have been less likely to take part had screening been a separate visit. Themes identified included preparedness for T1D and the long-term benefit outweighing short-term upset. The perceived volume of the capillary sample was a potential concern and needs optimising. Conclusions: Capillary IAb testing is a possible method to screen children for T1D. Aligning collection to the preschool vaccination visit can be convenient for families without the need for an additional visit. Competing Interests: Competing interests: REJB has been an independent advisor to Provention Bio. JAT consults for GSK, Vesalius Therapeutics, Precion and Immunocore. CMD has lectured for or has been involved as an advisor to the following companies: Novo Nordisk, Sanofi-Genzyme, Janssen, Servier, Lilly, AstraZeneca, Provention Bio, UCB, MSD, Vielo Bio, Avotres, Worg and Novartis. CMD holds a patent jointly with Midatech. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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