Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults

OBJECTIVE: In latent autoimmune diabetes of adults (LADA), the progression into insulin-dependent diabetes is usually faster than in type 2 diabetes (T2D) but the factors influencing this progression are not completely known. In this study, we searched for sensitive markers associated with early development of insulin dependence. DESIGN: The screening of 5568 T2D patients for glutamic acid decarboxylase autoantibodies (GAD65Ab) identified 276 LADA patients (M=131; F=145) and in 251 of them, tyrosine phosphatase-2 (IA-2Ab) and thyroperoxidase autoantibodies (TPOAbs), some clinical features and genotype variation of the main type 1 diabetes (T1D) disease susceptibility loci (HLA-DRB1 and HLA-DQB1) were analyzed. RESULTS: Four years after the diagnosis of diabetes, high GAD65Ab titer was not significantly associated with faster progression toward insulin deficiency (P=0.104). Patients with GAD65Ab and TPOAb or IA-2Ab or triple positivity for both islet and TPOAbs (GAD65Ab/IA-2Ab/TPOAb) showed a significantly faster disease progression (P=0.002). Among 104 TPOAb-positive LADA patients, 10 received replacement therapy (l-thyroxine), 43 showed high TSH levels (62.7% developed insulin dependence), and 3 had hyperthyroidism treated with methimazole. Multivariate analysis revealed a significant effect on disease progression only for TPOAb (P=0.022), female gender (P=0.036), low body mass index (BMI; P=0.001), and T1D high/intermediate risk HLA-DRB1/DQB1 genotypes grouped (P=0.020). CONCLUSIONS: High GAD65Ab titers per se are not a major risk factor for disease progression in LADA, while the number of positive autoantibodies and HLA DRB1-DQB1 genotypes at high risk for T1D are significant predictors. Moreover, clinical characteristics such as low BMI and female gender are more likely to identify patients who will require insulin therapy within 4 years of diagnosis.</br

Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults

OBJECTIVE: In latent autoimmune diabetes of adults (LADA), the progression into insulin-dependent diabetes is usually faster than in type 2 diabetes (T2D) but the factors influencing this progression are not completely known. In this study, we searched for sensitive markers associated with early development of insulin dependence. DESIGN: The screening of 5568 T2D patients for glutamic acid decarboxylase autoantibodies (GAD65Ab) identified 276 LADA patients (M=131; F=145) and in 251 of them, tyrosine phosphatase-2 (IA-2Ab) and thyroperoxidase autoantibodies (TPOAbs), some clinical features and genotype variation of the main type 1 diabetes (T1D) disease susceptibility loci (HLA-DRB1 and HLA-DQB1) were analyzed. RESULTS: Four years after the diagnosis of diabetes, high GAD65Ab titer was not significantly associated with faster progression toward insulin deficiency (P=0.104). Patients with GAD65Ab and TPOAb or IA-2Ab or triple positivity for both islet and TPOAbs (GAD65Ab/IA-2Ab/TPOAb) showed a significantly faster disease progression (P=0.002). Among 104 TPOAb-positive LADA patients, 10 received replacement therapy (l-thyroxine), 43 showed high TSH levels (62.7% developed insulin dependence), and 3 had hyperthyroidism treated with methimazole. Multivariate analysis revealed a significant effect on disease progression only for TPOAb (P=0.022), female gender (P=0.036), low body mass index (BMI; P=0.001), and T1D high/intermediate risk HLA-DRB1/DQB1 genotypes grouped (P=0.020). CONCLUSIONS: High GAD65Ab titers per se are not a major risk factor for disease progression in LADA, while the number of positive autoantibodies and HLA DRB1-DQB1 genotypes at high risk for T1D are significant predictors. Moreover, clinical characteristics such as low BMI and female gender are more likely to identify patients who will require insulin therapy within 4 years of diagnosi

Acqua Sorgente a nationwide citizen science project to monitor and study the Italian water springs

Groundwater is the most abundant reservoir of available freshwater and both communities and ecosystems are strongly dependent on it. In Europe, groundwater abstraction accounts for more than half of all tapped water. Water springs are the surface manifestations of groundwater and their physical and chemical characteristics can carry information on hydrodynamic processes, aquifer lithology, soil properties, and climatic conditions. Both natural ecosystems and human communities are deeply reliant on the availability of spring water, which is extensively exploited for drinking water supplies. Also, springs are crucial geographical and cultural elements of all territories and can constitute biodiversity hotspots, hosting numerous plant species and providing water to downstream ecosystems. Groundwater recharge, and consequently the permanence of water flow from springs, is closely linked to meteorological and climatic conditions that influence processes such as precipitation, evapotranspiration, and others. Current climate trends in Europe suggest declining groundwater recharge across many regions, threatening ecosystems and communities. These challenges are compounded by human activities, which can lead to the disappearance and pollution of natural springs. It is therefore essential to collectively adopt measures for the protection of springs that combine community awareness initiatives with community collaboration for monitoring activities at a large scale. Citizen science is a crucial approach for these purposes, contributing to clarify current scientific issues through active participation in science. In April 2024, the Italian Alpine Club (Club Alpino Italiano, CAI) launched the nationwide citizen science project, Acqua Sorgente. Leveraging CAI’s extensive network of over 800 local sections throughout Italy and 350,000 members, the project aims to: i) create and maintain an open-source national database of springs monitoring data; ii) foster community awareness on issues related to springs and water resources. Through CAI-developed applications, participants can record information such as the location, photographs, flow rate, electrical conductivity, and temperature of springs. Springs’ electrical conductivity and temperature are acquired by trained volunteers equipped with portable probes provided by the Alpine Club. The database already contains more than 800 validated springs’ monitoring data (https://maps.acquasorgente.cai.it/). Preliminary hydrological and hydrogeological analyses were developed on the collected data and included, but are not limited to: analysis of main drivers of springs’ temperature and electrical conductivity; springs’ role in sustaining a good conservation status in vegetation; interpolation of springs’ temperature and electrical conductivity at national scale. The analyses were integrated with a socio-hydrogeological questionnaire targeted to understand water resources and spring water perception. Furthermore, the project is engaged in dissemination activities to promote water awareness, including public events and educational programs for schools combining theoretical and practical lessons. This presentation will share reflections on the efforts and challenges involved in developing and sustaining such a large-scale citizen science project. Lastly, we hope to foster potential collaborations for research activities related to springs and water resources, which the Acqua Sorgente project aims to support