OBJECTIVE Most individuals with two or more islet autoantibodies progress to clinical type 1 diabetes. However, in some individuals, autoantibodies are subsequently lost. Here, our objectives were to determine the frequency of autoantibody loss (reversion) in multiple-autoantibody-positive individuals and to determine the association between reversion and progression to clinical disease. RESEARCH DESIGN AND METHODS We analyzed multiple-autoantibody-positive individuals participating in TrialNet's Pathway to Prevention Study for reversion and determined the effect of reversion on progression to clinical disease using a Cox regression analysis. RESULTS Of 3,284 multiple-autoantibody-positive subjects, reversion occurred in 134 (4.1%) and was associated with reduced incidence of clinical disease. Reversion occurred more frequently with older age, lower autoantibody titers, and fewer positive autoantibodies. CONCLUSIONS Although reversion of multiple-autoantibody positivity is rare, when it occurs, the risk of progressing to clinical disease is reduced. This suggests unknown mechanisms promoting immune remission in some individuals.

中文翻译：

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自身抗体逆转：改变多个自身抗体阳性个体的风险类别。

目的大多数具有两个或多个胰岛自身抗体的个体会发展为临床1型糖尿病。但是，在某些个体中，自身抗体随后会丢失。在这里，我们的目标是确定多种自身抗体阳性的个体中自身抗体丢失（回复）的频率，并确定回复与临床疾病进展之间的关联。研究设计和方法我们分析了参与TrialNet预防研究途径的多种自身抗体阳性个体进行逆转，并使用Cox回归分析确定了逆转对临床疾病进展的影响。结果在3,284名多自身抗体阳性受试者中，有134名（4.1％）发生了逆转，并且与临床疾病的发生率降低相关。随着年龄的增长，自身抗体滴度降低，阳性自身抗体减少，返发率更高。结论尽管多重自身抗体阳性的逆转很少见，但一旦发生，则降低了发展为临床疾病的风险。这表明在某些个体中促进免疫缓解的未知机制。