HEp-2 assays with corresponding autoantibodies are described in ref. 28 (link) in detail. Briefly, serum samples indicated in the figures or figure legends were diluted to an equal concentration of IgM (approximately 300 ng/mL anti–Insulin-IgM in both immunized samples) and applied onto the HEp-2 slides (EUROIMMUN, F191108VA). Anti–IgM-APC (allophycocyanin) (eBioscience) and anti–IgG-APC (eBioscience) were used for the visualization of ANA-IgM/-IgG.