Circulating Unmethylated Insulin DNA As a Biomarker of Human Beta Cell Death: A Multi-laboratory Assay Comparison

Cate Speake, Alyssa Ylescupidez, Daniel Neiman, Ruth Shemer, Benjamin Glaser, Sarah A. Tersey, Sahar Usmani-Brown, Pamela Clark, Joshua J. Wilhelm, Melena D. Bellin, Kevan C. Herold, Raghavendra G. Mirmira, Yuval Dor, Carmella Evans-Molina

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Context: There is an unmet need for biomarkers of pancreatic beta-cell death to improve early diagnosis of type 1 diabetes, enroll subjects into clinical trials, and assess treatment response. To address this need, several groups developed assays measuring insulin deoxyribonucleic acid (DNA) with unmethylated CpG sites in cell-free DNA. Unmethylated insulin DNA should be derived predominantly from beta-cells and indicate ongoing beta-cell death. Objective: To assess the performance of three unmethylated insulin DNA assays. Design and Participants: Plasma or serum samples from 13 subjects undergoing total pancreatectomy and islet autotransplantation were coded and provided to investigators to measure unmethylated insulin DNA. Samples included a negative control taken post-pancreatectomy but pretransplant, and a positive control taken immediately following islet infusion. We assessed technical reproducibility, linearity, and persistence of detection of unmethylated insulin DNA for each assay. Results: All assays discriminated between the negative sample and samples taken directly from the islet transplant bag; 2 of 3 discriminated negative samples from those taken immediately after islet infusion. When high levels of unmethylated insulin DNA were present, technical reproducibility was generally good for all assays. Conclusions: The measurement of beta cell cell-free DNA, including insulin, is a promising approach, warranting further testing and development in those with or at-risk for type 1 diabetes, as well as in other settings where understanding the frequency or kinetics of beta cell death could be useful.

Original languageEnglish (US)
Article numberdgaa008
JournalJournal of Clinical Endocrinology and Metabolism
Issue number3
StatePublished - Jan 8 2020

Bibliographical note

Funding Information:
Funding Statement: This research was performed using funding provided by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)-supported Human Islet Research Network Opportunity Pool Fund (HIRN, RRID:SCR_014393;; U01 DK104162 to CEM), and by JDRF under the Core for Assay Validation grants #3-SRA-2016-209-Q-R to S. Alice Long and 3-SRA-2019-791-S-B to CS. KCH received support from R01 DK057846, UC4 DK104205-01, and R21 AI135562. KCH and SUB have support from R43 DK116577. Dr. Bellin is supported by R01 DKI09914.

Publisher Copyright:
© 2020 Endocrine Society 2020.


  • Beta cell
  • cell-free DNA
  • islet transplantation
  • type 1 diabetes

PubMed: MeSH publication types

  • Comparative Study
  • Evaluation Study
  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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