Self‐reported lower respiratory tract infections and development of islet autoimmunity in children with the type 1 diabetes high‐risk HLA genotype: the MIDIA study

Rasmussen, Trond; Witsø, Elisabet; Tapia, German; Stene, Lars C.; Rønningen, Kjersti S.

doi:10.1002/dmrr.1258

Cited by 51 publications

(48 citation statements)

References 11 publications

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“…This association indicates that RIEs are not a good predictor of whether an individual child will seroconvert for islet autoantibodies. However, at a population level, comparing groups with different RIE rates, the observed association is relatively consistent by country, remaining when adjusting for many other risk factors, and the association is in line with previous findings on type 1 diabetes [1, 4–7], which suggests a biological mechanism is probably present. Further research is required to understand whether the moderate effect of RIE on islet autoimmunity is due to the role of specific microbes or interactions with other unknown risk factors.…”

Section: Discussionsupporting

confidence: 89%

“…The present prospective study consisting of almost 8000 participants has confirmed the findings of two smaller prospective studies (the Norwegian MIDIA study with 885 participants and German BABYDIET study with 148 participants [4, 5]) of the risk association between respiratory infection and islet autoimmunity. The observed temporal pattern suggests an islet autoimmunity-triggering effect by respiratory infections.…”

Section: Discussionsupporting

confidence: 86%

“…The mode of action may depend on several factors, like microbe species, anatomical location of infection, host’s age and the intensity of beta cell stress induced by the infection. Parent-reported early childhood respiratory infections showed no association with islet autoimmunity in a prospective study in the USA [3], whereas respiratory infections were associated with islet autoimmunity in two small European prospective studies; the environmental triggers for type 1 diabetes study (MIDIA) and a primary dietary intervention study to reduce the risk of islet autoimmunity in children at increased risk for type 1 diabetes (BABYDIET) [4, 5]. An analysis of statutory health insurance claims data of individuals from Bavaria, Germany, suggested an association between early life respiratory infections and later clinical type 1 diabetes [6].…”

Section: Introductionmentioning

confidence: 99%

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Respiratory infections are temporally associated with initiation of type 1 diabetes autoimmunity: the TEDDY study

et al. 2017

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Aims/hypothesis Respiratory infections and onset of islet autoimmunity are reported to correlate positively in two small prospective studies. The Environmental Determinants of Diabetes in the Young (TEDDY) study is the largest prospective international cohort study on the environmental determinants of type 1 diabetes that regularly monitors both clinical infections and islet autoantibodies. The aim was to confirm the influence of reported respiratory infections and to further characterise the temporal relationship with autoantibody seroconversion. Methods During the years 2004–2009, 8676 newborn babies with HLA genotypes conferring an increased risk of type 1 diabetes were enrolled at 3 months of age to participate in a 15 year follow-up. In the present study, the association between parent-reported respiratory infections and islet autoantibodies at 3 month intervals up to 4 years of age was evaluated in 7869 children. Time-dependent proportional hazard models were used to assess how the timing of respiratory infections related to persistent confirmed islet autoimmunity, defined as autoantibody positivity against insulin, GAD and/or insulinoma antigen-2, concordant at two reference laboratories on two or more consecutive visits. Results In total, 87,327 parent-reported respiratory infectious episodes were recorded while the children were under study surveillance for islet autoimmunity, and 454 children seroconverted. The number of respiratory infections occurring in a 9 month period was associated with the subsequent risk of autoimmunity (p < 0.001). For each 1/year rate increase in infections, the hazard of islet autoimmunity increased by 5.6% (95% CI 2.5%, 8.8%). The risk association was linked primarily to infections occurring in the winter (HR 1.42 [95% CI 1.16, 1.74]; p < 0.001). The types of respiratory infection independently associated with autoimmunity were common cold, influenza-like illness, sinusitis, and laryngitis/tracheitis, with HRs (95% CI) of 1.38 (1.11, 1.71), 2.37 (1.35, 4.15), 2.63 (1.22, 5.67) and 1.76 (1.04, 2.98), respectively. Conclusions/interpretation Recent respiratory infections in young children correlate with an increased risk of islet autoimmunity in the TEDDY study. Further studies to identify the potential causative viruses with pathogen-specific assays should focus especially on the 9 month time window leading to autoantibody seroconversion.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Respiratory infections are temporally associated with initiation of type 1 diabetes autoimmunity: the TEDDY study

et al. 2017

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“…Results were once again heterogeneous, but studies in which the information on maternal smoking in pregnancy was registered before or soon after birth (rather than by retrospective recall) tended to be consistent with the initial observation by Dahlquist and Källén [76][77][78][79]. We identified published data from four birth cohort studies with longitudinal follow-up for islet autoantibodies [62,63,80,81]. While the total number of cases was only 244, and none of the studies showed significant associations, the point estimates for the relative risk appeared quite homogeneous at about 0.5 to 0.7.…”

Section: Caesarean Section Vs Notmentioning

confidence: 74%

The prenatal environment and type 1 diabetes

Stene

Gale

2013

Diabetologia

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“…Virus infections have long been considered as one of the most likely candidates because certain viruses are known to infect the pancreas and cause a T1D-like disease in animals [4,5]. Two recent studies have shown that respiratory infections precede the initiation of the b-cell damaging process in children who later progress to T1D [6,7]. One specific virus group, enteroviruses (EVs), has raised particular interest since it has been connected to T1D in numerous studies [4,5,8,9].…”

Section: Abstract: Antiviral Drugs • Enterovirus • Type 1 Diabetes • mentioning

confidence: 99%

Developing a vaccine for Type 1 diabetes through targeting enteroviral infections

Hyöty¹,

Knip²

2014

Expert Review of Vaccines

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Type 1 diabetes (T1D) is a chronic disease caused by the destruction of insulin producing β-cells in the pancreas. Studies carried out during the past decades have implied that enteroviruses could be an important causative agent. These findings have generated efforts aiming at developing vaccines against these viruses and testing their efficacy against T1D in clinical trials. Extensive work has been carried out to define the serotype of enteroviruses which are linked to T1D and which should be included in the vaccine, and experimental vaccines have been shown to be effective and safe in mouse models. Large-scale studies are currently in progress to increase the confidence in the scientific concept of the enterovirus-diabetes association, paralleling the efforts aimed at starting the clinical development of the vaccine. This review summarizes recent progress in this field and the scenarios regarding this development process.

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Self‐reported lower respiratory tract infections and development of islet autoimmunity in children with the type 1 diabetes high‐risk HLA genotype: the MIDIA study

Abstract: Self-reported lower respiratory tract infections were associated with increased risk of islet autoimmunity in early infancy.

Cited by 51 publications

References 11 publications

Respiratory infections are temporally associated with initiation of type 1 diabetes autoimmunity: the TEDDY study

Respiratory infections are temporally associated with initiation of type 1 diabetes autoimmunity: the TEDDY study

The prenatal environment and type 1 diabetes

Developing a vaccine for Type 1 diabetes through targeting enteroviral infections

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