1
|
Gao Y, Chen S, Gu WY, Fang C, Huang YT, Gao Y, Lu Y, Su J, Wu M, Zhang J, Xu M, Zhang ZL. Genome-wide association study reveals novel loci for adult type 1 diabetes in a 5-year nested case-control study. World J Diabetes 2021; 12:2073-2086. [PMID: 35047121 PMCID: PMC8696645 DOI: 10.4239/wjd.v12.i12.2073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/03/2021] [Accepted: 11/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) is a severe and prevalent metabolic disease. Due to its high heredity, an increasing number of genome-wide association studies have been performed, most of which were from hospital-based case-control studies with a relatively small sample size. The association of single nucleotide polymorphisms (SNPs) and T1D has been less studied and is less understood in natural cohorts.
AIM To investigate the significant variants of T1D, which could be potential biomarkers for T1D prediction or even therapy.
METHODS A genome-wide association study (GWAS) of adult T1D was performed in a nested case-control study (785 cases vs 804 controls) from a larger 5-year cohort study in Suzhou, China. Potential harmful or protective SNPs were evaluated for T1D. Subsequent expression and splicing quantitative trait loci (eQTL and sQTL) analyses were carried out to identify target genes modulated by these SNPs.
RESULTS A harmful SNP for T1D, rs3117017 [odds ratio (OR) = 3.202, 95% confidence interval (CI): 2.296-4.466, P = 9.33 × 10-4] and three protective SNPs rs55846421 (0.113, 0.081-0.156, 1.76 × 10-9), rs75836320 (0.283, 0.205-0.392, 1.07 × 10-4), rs362071 (0.568, 0.495-0.651, 1.66 × 10-4) were identified. Twenty-two genes were further identified as potential candidates for T1D onset.
CONCLUSION We identified a potential genetic basis of T1D, both protective and harmful, using a GWAS in a larger nested case-control study of a Chinese population.
Collapse
Affiliation(s)
- Yan Gao
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, Suzhou 215123, Jiangsu Province, China
- Institute of Suzhou Biobank, Suzhou Center for Disease Prevention and Control, Suzhou 215004, Jiangsu Province, China
| | - Shi Chen
- Department of Public Health Sciences, University of North Carolina Charlotte, NC 28223, United States
- School of Data Science, University of North Carolina Charlotte, NC 28223, United States
| | - Wen-Yong Gu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Chen Fang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
- Department of Clinical Nutrition, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Yi-Ting Huang
- Clinical Nutrition Department, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Yue Gao
- Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
- Public Health Research Institute of Jiangsu Province, Nanjing 210009, Jiangsu Province, China
| | - Yan Lu
- Institute of Suzhou Biobank, Suzhou Center for Disease Prevention and Control, Suzhou 215004, Jiangsu Province, China
| | - Jian Su
- Department of Chronic Disease Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
| | - Ming Wu
- Department of Chronic Disease Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
| | - Jun Zhang
- Institute of Suzhou Biobank, Suzhou Center for Disease Prevention and Control, Suzhou 215004, Jiangsu Province, China
| | - Ming Xu
- Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
- Public Health Research Institute of Jiangsu Province, Nanjing 210009, Jiangsu Province, China
| | - Zeng-Li Zhang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, Suzhou 215123, Jiangsu Province, China
| |
Collapse
|
2
|
Abstract
During the course of mammalian evolution, there has been a close relationship between microbes residing in the gastrointestinal (GI) tract and the mammalian host. Although the host provides the microbes with a warm environment and nutrients, they, in turn, undergo various metabolic processes that aid the host. The host has developed weapons against microbes that are considered foreign, as well as mechanisms to tolerate and live synergistically with most of the microbes in the GI tract. This relationship is proving to be important not only in the neonatal period and during infancy, but it is becoming increasingly evident that microbial colonization in early life may affect the individual's health throughout life. Here we will review this relationship in terms of health and disease, with a focus on the aspects of this relationship during maturation of the host.
Collapse
Affiliation(s)
- Josef Neu
- Pediatrics, College of Medicine, University of Florida, Gainesville, FL 32510, USA.
| | | | | |
Collapse
|
3
|
Jacobsen R, Frederiksen P, Heitmann BL. Exposure to sunshine early in life prevented development of type 1 diabetes in Danish boys. J Pediatr Endocrinol Metab 2016; 29:417-24. [PMID: 26673019 DOI: 10.1515/jpem-2015-0393] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 11/02/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND We aimed to assess the association between exposure to sunshine during gestation and the risk of type 1 diabetes (T1D) in Danish children. METHODS The study population included 331,623 individuals born in Denmark from 1983 to 1988; 886 (0.26%) developed T1D by the age of 15 years. The values of sunshine hours were obtained from the Danish Meteorological Institute. Gestational exposure to sunshine was calculated by summing recorded monthly sunshine hours during the full 9 months prior to the month of birth. The linear variable then was split into two categories separated by the median value. RESULTS AND CONCLUSIONS Cox regression models showed that more sunshine during the third gestational trimester was associated with lower hazards (HR) of T1D at age 5-9 years in males: HR (95% CI): 0.60 (0.43-0.84), p=0.003. Our results should be considered in the context of evidence-based recommendations to the public about skin protection from the sun.
Collapse
|
4
|
Vitamin D fortification and seasonality of birth in type 1 diabetic cases: D-tect study. J Dev Orig Health Dis 2015; 7:114-9. [PMID: 26503327 DOI: 10.1017/s2040174415007849] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Fortification of margarine with vitamin D was mandatory in Denmark during 1961-1985. The aim of the study was to assess whether gestational and early infancy exposure to margarine fortification was associated with seasonality of birth in Danish type 1 diabetes (T1D) patients. The risks of T1D in Danes born during various exposure periods around margarine fortification termination in 1985 were analyzed. As expected, the T1D hazards in males unexposed to margarine fortification and born in spring were higher than in males born in autumn: relevant hazard ratios (95% confidence intervals) in various exposure groups ranged from 1.74 (1.112/2.708) to 37.43 (1.804/776.558). There were no indications of seasonality of birth in males exposed to fortification, nor in both exposed and unexposed females. The study suggests that early life exposure to low-dose vitamin D from fortified food eliminates seasonality of birth in T1D male patients. Further studies are required to investigate the identified gender differences.
Collapse
|
5
|
Ostrauskas R. The prevalence of type 1 diabetes mellitus among 15-34-year-aged Lithuanian inhabitants during 1991-2010. Prim Care Diabetes 2015; 9:105-111. [PMID: 25132138 DOI: 10.1016/j.pcd.2014.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 06/06/2014] [Accepted: 07/22/2014] [Indexed: 12/15/2022]
Abstract
AIMS To summarize the data on the prevalence of type 1 diabetes mellitus among 15-34-year-aged Lithuania inhabitants (1991-2010). METHODS New prevalent cases consist of growing-up patients with diabetes onset in childhood, i.e., up to 14 years, new onset 15-34-year-aged type 1 diabetic patients Lithuanian inhabitants, and immigrants. The data on type 1 diabetes was collected with the help of general practitioners and regional endocrinologists in Lithuania. RESULTS On 31 December 1991, there were 1202 adolescent and adult 15-34-year-aged patients with type 1 diabetes mellitus or 103.59 per 100,000 inhabitants of the same age group (95% Poisson CI 97.90-109.62), and at the end of 2010 - 1533 or 187.80 (178.63-197.44), respectively in Lithuania. During 19-year period the mean increase of type 1 diabetic patients was 1.25±1.94% per year or 1.47±2.74 per 100,000 inhabitants per mean year of the study period (for males 1.42±2.14% or 1.69±3.05/100,000 and for females 1.05±1.99%, or 1.24±2.92/100,000). Regression-based linear trends showed that the prevalence of type 1 diabetes mellitus in 15-34-year-age group had a tendency to increase among males (r=0.953; p<0.001) and females (r=0.970; p<0.001). The age adjusted prevalence frequencies for males and females in 1991 were correspondingly 102.81/100,000 and 104.55/100,000, and in 2010 - 193.75 and 182.01. CONCLUSION The prevalence of type 1 diabetes mellitus among 15-34-year-age males and females had a tendency to increase during 1991-2010.
Collapse
Affiliation(s)
- Rytas Ostrauskas
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| |
Collapse
|
6
|
Shulman LM, Hampe CS, Ben-Haroush A, Perepliotchikov Y, Vaziri-Sani F, Israel S, Miller K, Bin H, Kaplan B, Laron Z. Antibodies to islet cell autoantigens, rotaviruses and/or enteroviruses in cord blood and healthy mothers in relation to the 2010-2011 winter viral seasons in Israel: a pilot study. Diabet Med 2014; 31:681-5. [PMID: 24494628 PMCID: PMC4061376 DOI: 10.1111/dme.12404] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/20/2013] [Accepted: 01/28/2014] [Indexed: 12/14/2022]
Abstract
AIMS To determine whether antivirus and/or islet cell antibodies can be detected in healthy pregnant mothers without diabetes and/or their offspring at birth in two winter viral seasons. METHODS Maternal and cord blood sera from 107 healthy pregnant women were tested for islet cell autoantibodies using radioligand binding assays and for anti-rotavirus and anti-CoxB3 antibody using an enzyme-linked immunosorbent assay. RESULTS Glutamic acid decarboxylase (GAD)65 autoantibodies and rotavirus antibodies, present in both maternal and cord blood sera, correlated with an odds ratio of 6.89 (95% CI: 1.01-46.78). For five, 22 and 17 pregnancies, antibodies to GAD65, rotavirus and CoxB3, respectively, were detected in cord blood only and not in the corresponding maternal serum. In 10 pregnancies, rotavirus antibody titres in the cord blood exceeded those in the corresponding maternal serum by 2.5-5-fold. Increased antibody titres after the 20(th) week of gestation suggested CoxB3 infection in one of the 20 pregnancies and rotavirus in another. CONCLUSION The concurrent presence of GAD65 antibodies in cord blood and their mothers may indicate autoimmune damage to islet cells during gestation, possibly caused by cross-placental transmission of viral infections and/or antivirus antibodies. Cord blood antibody titres that exceed those of the corresponding maternal sample by >2.5-fold, or antibody-positive cord blood samples with antibody-negative maternal samples, may imply an active in utero immune response by the fetus.
Collapse
Affiliation(s)
- L M Shulman
- Central Virology Laboratory, Public Health Services MOH, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Pierce BG, Eberwine R, Noble JA, Habib M, Shulha HP, Weng Z, Blankenhorn EP, Mordes JP. The Missing Heritability in T1D and Potential New Targets for Prevention. J Diabetes Res 2013; 2013:737485. [PMID: 23691517 PMCID: PMC3647582 DOI: 10.1155/2013/737485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/13/2013] [Indexed: 12/27/2022] Open
Abstract
Type 1 diabetes (T1D) is a T cell-mediated disease. It is strongly associated with susceptibility haplotypes within the major histocompatibility complex, but this association accounts for an estimated 50% of susceptibility. Other studies have identified as many as 50 additional susceptibility loci, but the effect of most is very modest (odds ratio (OR) <1.5). What accounts for the "missing heritability" is unknown and is often attributed to environmental factors. Here we review new data on the cognate ligand of MHC molecules, the T cell receptor (TCR). In rats, we found that one allele of a TCR variable gene, V β 13A, is strongly associated with T1D (OR >5) and that deletion of V β 13+ T cells prevents diabetes. A role for the TCR is also suspected in NOD mice, but TCR regions have not been associated with human T1D. To investigate this disparity, we tested the hypothesis in silico that previous studies of human T1D genetics were underpowered to detect MHC-contingent TCR susceptibility. We show that stratifying by MHC markedly increases statistical power to detect potential TCR susceptibility alleles. We suggest that the TCR regions are viable candidates for T1D susceptibility genes, could account for "missing heritability," and could be targets for prevention.
Collapse
Affiliation(s)
- Brian G. Pierce
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Ryan Eberwine
- Department of Microbiology and Immunology, Center for Immunogenetics and Inflammatory Diseases, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Janelle A. Noble
- Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA
| | - Michael Habib
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Hennady P. Shulha
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Zhiping Weng
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Elizabeth P. Blankenhorn
- Department of Microbiology and Immunology, Center for Immunogenetics and Inflammatory Diseases, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - John P. Mordes
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| |
Collapse
|
8
|
Hussen HI, Yang D, Cnattingius S, Moradi T. Type I diabetes among children and young adults: the role of country of birth, socioeconomic position and sex. Pediatr Diabetes 2013; 14:138-48. [PMID: 22925403 DOI: 10.1111/j.1399-5448.2012.00904.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/19/2012] [Accepted: 06/20/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate associations between country of birth, parental country of birth, and education with respect to incidence rate and time trends of type 1 diabetes mellitus (T1DM) among children and young adults. METHODS We followed a nation-wide cohort of 4 469 671 males and 4 231 680 females aged 0-30 years between 1969 and 2008. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) for T1DM were calculated using Poisson regression models. We further calculated age-standardized rates (ASRs) of T1DM, using the world population as standard. RESULTS During the study period, the ASR of T1DM increased among children younger than 15 years, but not among young adults (15-30 years). Compared with Swedish-born children, male and female immigrant children had 44 and 42% lower IRR of TIDM, respectively. Among offspring to immigrants, corresponding decreases in IRRs were 27 and 24%, respectively. Compared with children to parents with high education, male children to parents with low education had a 10% decreased IRR of T1DM, while no effect was observed among females. The IRR of T1DM increased with increasing age and calendar time of follow-up in both sexes (p-for trend <0.0001). In young adults, the IRR among immigrants decreased by 32% in males and 22% in females, while corresponding reductions in IRRs were less in offspring to immigrants. CONCLUSIONS We found a lower IRR of T1DM among offspring to immigrants, but especially among young immigrants compared with Sweden-born individuals. The findings show that environmental factors are important in the etiology of T1DM.
Collapse
Affiliation(s)
- Hozan Ismael Hussen
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77, Stockholm, Sweden.
| | | | | | | |
Collapse
|
9
|
Bortell R, Yang C. The BB rat as a model of human type 1 diabetes. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2013; 933:31-44. [PMID: 22893399 DOI: 10.1007/978-1-62703-068-7_3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The BB rat is an important rodent model of human type 1 diabetes (T1D) and has been used to study mechanisms of diabetes pathogenesis as well as to investigate potential intervention therapies for clinical trials. The Diabetes-Prone BB (BBDP) rat spontaneously develops autoimmune T1D between 50 and 90 days of age. The Diabetes-Resistant BB (BBDR) rat has similar diabetes-susceptible genes as the BBDP, but does not become diabetic in viral antibody-free conditions. However, the BBDR rat can be induced to develop T1D in response to certain treatments such as regulatory T cell (T(reg)) depletion, toll-like receptor ligation, or virus infection. These diabetes-inducible rats develop hyperglycemia under well-controlled circumstances and within a short, predictable time frame (14-21 days), thus facilitating their utility for investigations of specific stages of diabetes development. Therefore, these rat strains are invaluable models for studying autoimmune diabetes and the role of environmental factors in its development, of particular importance due to the influx of studies associating virus infection and human T1D.
Collapse
Affiliation(s)
- Rita Bortell
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
| | | |
Collapse
|
10
|
Novikova L, Smirnova IV, Rawal S, Dotson AL, Benedict SH, Stehno-Bittel L. Variations in rodent models of type 1 diabetes: islet morphology. J Diabetes Res 2013; 2013:965832. [PMID: 23762878 PMCID: PMC3671304 DOI: 10.1155/2013/965832] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/18/2013] [Indexed: 12/15/2022] Open
Abstract
Type 1 diabetes (T1D) is characterized by hyperglycemia due to lost or damaged islet insulin-producing β -cells. Rodent models of T1D result in hyperglycemia, but with different forms of islet deterioration. This study focused on 1 toxin-induced and 2 autoimmune rodent models of T1D: BioBreeding Diabetes Resistant rats, nonobese diabetic mice, and Dark Agouti rats treated with streptozotocin. Immunochemistry was used to evaluate the insulin levels in the β -cells, cell composition, and insulitis. T1D caused complete or significant loss of β -cells in all animal models, while increasing numbers of α -cells. Lymphocytic infiltration was noted in and around islets early in the progression of autoimmune diabetes. The loss of lymphocytic infiltration coincided with the absence of β -cells. In all models, the remaining α - and δ -cells regrouped by relocating to the islet center. The resulting islets were smaller in size and irregularly shaped. Insulin injections subsequent to induction of toxin-induced diabetes significantly preserved β -cells and islet morphology. Diabetes in animal models is anatomically heterogeneous and involves important changes in numbers and location of the remaining α - and δ -cells. Comparisons with human pancreatic sections from healthy and diabetic donors showed similar morphological changes to the diabetic BBDR rat model.
Collapse
Affiliation(s)
- Lesya Novikova
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Irina V. Smirnova
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Sonia Rawal
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Abby L. Dotson
- Department of Molecular Biosciences, University of Kansas, Lawrence, KS 66045, USA
| | - Stephen H. Benedict
- Department of Molecular Biosciences, University of Kansas, Lawrence, KS 66045, USA
| | - Lisa Stehno-Bittel
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
- *Lisa Stehno-Bittel:
| |
Collapse
|
11
|
Mellouli F, Ksouri H, Lakhal A, Torjmen L, Ladeb S, Ben Othman T, Hmida S, Bejaoui M. Autoimmune polyglandular syndrome type II after bone marrow transplant: real transfer or acceleration of a programmed disease? EXP CLIN TRANSPLANT 2012; 10:76-80. [PMID: 22309426 DOI: 10.6002/ect.2011.0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report a case of autoimmune polyglandular syndrome type II that developed in an 11-year-old boy with homozygous sickle cell disease after allogeneic bone marrow transplant; the donor was his father, who was human leukocyte antigen identical and had vitiligo. On day 24 after transplant, the patient developed grade 1 acute graft-versus-host disease, which was controlled over a period of 3 months with corticosteroid-induced immunosuppression. Full donor engraftment was documented on day 31 after transplant, and this was further confirmed on days 59, 231, 321, 472, 549, and 720. Three months after transplant, the recipient developed adrenal insufficiency, and at 13 months, he developed vitiligo. Seventeen months after transplant, autoimmune thyroid disease, positive for thyroid peroxidase and thyroglobulin autoantibodies, was diagnosed. At the same time, we identified adrenal insufficiency in the donor. We analyzed a serum sample from the recipient for autoantibody markers for type 1 autoimmune diabetes mellitus. The sample was positive for antiglutamic acid decarboxylase. Antibody against 21-hydroxylase enzyme was also found (261 U/mL; normal value, < 1 U/mL). We conclude that the recipient developed autoimmune polyglandular syndrome type II after bone marrow transplant from his father, who was probably affected by the same syndrome.
Collapse
Affiliation(s)
- Fethi Mellouli
- Service d'Immuno-Hematologie Pediatrique, Centre National de Greffe de Moelle Osseuse, Centre National de Transfusion Sanguine, Tunis, Tunisia
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Elliott JC, Lucas RM, Clements MS, Bambrick HJ. Population density determines the direction of the association between ambient ultraviolet radiation and type 1 diabetes incidence. Pediatr Diabetes 2010; 11:394-402. [PMID: 19968813 DOI: 10.1111/j.1399-5448.2009.00620.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Type 1 diabetes incidence has increased rapidly over the last 20 years, and ecological studies show inverse latitudinal gradients for both incidence and prevalence. Some studies have found season of birth or season of diagnosis effects. Together these findings suggest an important role for environmental factors in disease etiology. OBJECTIVE To examine whether type 1 diabetes incidence varies in relation to ambient ultraviolet radiation (UVR) in Australian children. METHODS We used case records of 4773 children aged 0-14 yr from the Australian National Diabetes Register to estimate type 1 diabetes incidence in relation to residential ambient UVR, both as a continuous variable and in four categories. We examined season of birth and season of diagnosis and variation in these parameters and in age at diagnosis, in relation to ambient UVR. RESULTS Overall incidence was 20 per 100 000 population with no sex difference. There was a statistically significant trend toward winter diagnosis (adjusted RR = 1.22, 95% CI 1.13-1.33, p<0.001) but no apparent season of birth effect. Incidence in the highest UVR category was significantly lower than in the lowest UVR category (RR = 0.85, 95% CI 0.75-0.96). We found an inverse association between incidence and ambient UVR that was present only at low population densities; at high population densities type 1 diabetes incidence increased with increasing ambient UVR. CONCLUSION In low population density, largely rural environments, ambient UVR may better reflect the personal UV dose, with the latter being protective for the development of type 1 diabetes. This effect is lost or reversed in high population density, largely urban, environments.
Collapse
Affiliation(s)
- Jane C Elliott
- ANU Medical School, The Australian National University, Canberra, ACT, Australia
| | | | | | | |
Collapse
|
13
|
Tirabassi RS, Guberski DL, Blankenhorn EP, Leif JH, Woda BA, Liu Z, Winans D, Greiner DL, Mordes JP. Infection with viruses from several families triggers autoimmune diabetes in LEW*1WR1 rats: prevention of diabetes by maternal immunization. Diabetes 2010; 59:110-8. [PMID: 19794063 PMCID: PMC2797911 DOI: 10.2337/db09-0255] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The contribution of antecedent viral infection to the development of type 1 diabetes in humans is controversial. Using a newer rat model of the disease, we sought to 1) identify viruses capable of modulating diabetes penetrance, 2) identify conditions that increase or decrease the diabetogenicity of infection, and 3) determine whether maternal immunization would prevent diabetes. RESEARCH DESIGN AND METHODS About 2% of LEW*1WR1 rats develop spontaneous autoimmune diabetes, but disease penetrance is much higher if weanling rats are exposed to environmental perturbants including Kilham rat virus (KRV). We compared KRV with other viruses for diabetogenic activity. RESULTS Both KRV and rat cytomegalovirus (RCMV) induced diabetes in up to 60% of LEW*1WR1 rats, whereas H-1, vaccinia, and Coxsackie B4 viruses did not. Simultaneous inoculation of KRV and RCMV induced diabetes in 100% of animals. Pretreatment of rats with an activator of innate immunity increased the diabetogenicity of KRV but not RCMV and was associated with a moderate rate of diabetes after Coxsackie B4 and vaccinia virus infection. Inoculation of LEW*1WR1 dams with both KRV and RCMV prior to pregnancy protected weanling progeny from virus-induced diabetes in a virus-specific manner. CONCLUSIONS Exposure to viruses can affect the penetrance of autoimmune diabetes in genetically susceptible animals. The diabetogenicity of infection is virus specific and is modified by immunomodulation prior to inoculation. Maternal immunization protects weanlings from virus-induced diabetes, suggesting that modification of immune responses to infection could provide a means of preventing islet autoimmunity.
Collapse
|
14
|
Moltchanova EV, Schreier N, Lammi N, Karvonen M. Seasonal variation of diagnosis of Type 1 diabetes mellitus in children worldwide. Diabet Med 2009; 26:673-8. [PMID: 19573115 DOI: 10.1111/j.1464-5491.2009.02743.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS To determine if there is a worldwide seasonal pattern in the clinical onset of Type 1 diabetes. METHODS Analysis of the seasonality in diagnosis of Type 1 diabetes was based on the incidence data in 0- to 14-year-old children collected by the World Health Organization Diabetes Mondiale (WHO DiaMond) Project over the period 1990-1999. One hundred and five centres from 53 countries worldwide provided enough data for the seasonality analysis. The incidence seasonality patterns were also determined for age- and sex-specific groups. RESULTS Forty-two out of 105 centres exhibited significant seasonality in the incidence of Type 1 diabetes (P < 0.05). The existence of significant seasonal patterns correlated with higher level of incidence and of the average yearly counts. The correlation disappeared after adjustment for latitude. Twenty-eight of those centres had peaks in October to January and 33 had troughs in June to August. Two out of the four centres with significant seasonality in the southern hemisphere demonstrated a different pattern with a peak in July to September and a trough in January to March. CONCLUSIONS The seasonality of the incidence of Type 1 diabetes mellitus in children under 15 years of age is a real phenomenon, as was reported previously and as is now demonstrated by this large standardized study. The seasonality pattern appears to be dependent on the geographical position, at least as far as the northern/southern hemisphere dichotomy is concerned. However, more data are needed on the populations living below the 30th parallel north in order to complete the picture.
Collapse
Affiliation(s)
- E V Moltchanova
- National Institute for Health and Welfare, Dept of Chronic Disease Prevention, Diabetes Prevention Unit, Helsinki, Finland.
| | | | | | | |
Collapse
|
15
|
Badenhoop K, Kahles H, Seidl C, Kordonouri O, Lopez ER, Walter M, Rosinger S, Ziegler A, Böhm BO. MHC-environment interactions leading to type 1 diabetes: feasibility of an analysis of HLA DR-DQ alleles in relation to manifestation periods and dates of birth. Diabetes Obes Metab 2009; 11 Suppl 1:88-91. [PMID: 19143820 PMCID: PMC2759302 DOI: 10.1111/j.1463-1326.2008.01008.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AIM The region on chromosome 6p21 (IDDM1) confers the largest part of genetic susceptibility to type 1 diabetes (T1D) with particular human leucocyte antigen (HLA) alleles predisposing and others protecting from it. As T1D is primarily a "sporadic" disease, the pathophysiology must involve gene-environment interactions. We searched for indirect evidence for such major histocompatibility complex (MHC)-environment interactions by asking two questions: (i) can the degree of an HLA association vary over time periods? and (ii) if a prenatal event like an intrauterine infection - that might cluster in seasons - leads to differences of HLA associations in patients with particular birth months? METHODS We screened the Type 1 Diabetes Genetics Consortium (T1DGC) database (in addition our own database and the original UK, US and SCAND databases) for MHC DR-DQ and CTLA4 associations. First, we separated the groups of patients with onset of disease before 1980 in comparison with onset after 1980. Second, we analysed the data according to dates of birth (grouped in months). Not all patients' dates of birth or manifestation periods were available, leading to different group sizes. There were 282 patients analysed for manifestation periods and 329 for birth month. RESULTS The cohorts of manifestation before 1980 demonstrated a significantly lower frequency of DQ2/X (2 vs. 14.2%; p = 0.03). There was a trend for DQ8/x to be more frequent for manifestations before 1980 (34 vs. 21.6%; p < 0.10). Other alleles did not differ significantly. The months of birth were not evenly distributed. Significant deviations from the whole group were seen in August (DQ2/8 trough and DQx/x high), whereas birth in September was more frequent in DQ8/x or DQ8/8 carriers. This pattern was significantly different from the expected distribution of months at birth (13.9 vs. 7.6%; p < 0.04). CONCLUSIONS We demonstrate the feasibility of an analysis that searches for indirect evidence of gene-environment interactions. These preliminary data need to be confirmed in larger data sets.
Collapse
Affiliation(s)
- K Badenhoop
- Department of Medicine, Division of Endocrinology, University Hospital Frankfurt, Frankfurt am Main, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Lewy H, Rotstein A, Kahana E, Marrosu MG, Cocco E, Laron Z. Juvenile multiple sclerosis similar to type I diabetes mellitus has a seasonality of month of birth which differs from that in the general population. J Pediatr Endocrinol Metab 2008; 21:473-7. [PMID: 18655530 DOI: 10.1515/jpem.2008.21.5.473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hadas Lewy
- Endocrinology and Diabetes Research Unit, Schneider Children's Medical Center, Petah Tikva, Israel
| | | | | | | | | | | |
Collapse
|
17
|
Ballarini A, Lee-Kirsch MA. Genetic Dissection of Autoimmune Polyendocrine Syndrome Type 2: Common Origin of a Spectrum of Phenotypes. Ann N Y Acad Sci 2007; 1110:159-65. [PMID: 17911431 DOI: 10.1196/annals.1423.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Autoimmune diseases constitute a heterogeneous group of disorders characterized by the loss of immune tolerance to self-antigens. Despite their distinct clinical picture, there is growing evidence that common molecular mechanisms may contribute to the whole spectrum of autoimmune diseases. This theory is strongly supported by the existence of the autoimmune polyendocrine syndromes (APS). Thus, the clinical diagnosis of APS1 is made in an individual who presents with at least two out of three cardinal symptoms, namely autoimmune Addison's disease, autoimmune hypoparathyroidism, and mucocutaneous candidiasis. APS1 is a rare autosomal recessive syndrome caused by mutations in the autoimmune regulator (AIRE) gene. APS2, which occurs at a much higher frequency, is classically defined as the coexistence of autoimmune Addison's disease, autoimmune thyroid disease, and/or type 1 diabetes. In contrast to APS1, the precise modes of inheritance and the genetic causes underlying APS2 remain unknown. Identification of genetic factors predisposing to this syndrome may contribute to our understanding of common mechanisms involved in autoimmunity.
Collapse
Affiliation(s)
- Annalisa Ballarini
- Klinik für Kinder- und Jugendmedizin, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | | |
Collapse
|
18
|
Vaiserman AM, Carstensen B, Voitenko VP, Tronko MD, Kravchenko VI, Khalangot MD, Mechova LV. Seasonality of birth in children and young adults (0-29 years) with type 1 diabetes in Ukraine. Diabetologia 2007; 50:32-5. [PMID: 17093948 DOI: 10.1007/s00125-006-0456-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 07/31/2006] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Numerous epidemiological studies have shown differences in seasonality of birth patterns between the general population and the group who develop type 1 diabetes mellitus. This finding indicates that environmental factors operating during pre- and/or postnatal development could be aetiologically important. We examined whether the pattern of month of birth for type 1 diabetes patients in Ukraine differs from that for total live births. METHODS Data consist of prevalent cases of type 1 diabetes in Ukraine by the end of 2003. Cases are restricted to persons born after 1 January 1960, diagnosed with type 1 diabetes before the age of 30 years (n = 20,117). People born during the same time in the general population (n = 29,105,560) were the reference standard. Seasonal patterns were estimated using logistic regression with harmonic terms. RESULTS We found a strongly significant seasonal pattern of type 1 diabetes incidence rates (p < 0.001), with the lowest rates in December and the highest in April. The rate ratio between the extremes was 1.32 (95% CI 1.27-1.39). Tests for seasonal patterns in subgroups defined by sex and age or by sex and date of birth were all significant with p values less than 0.02. We found no interactions with sex (p = 0.142) or age at diagnosis (p = 0.207), but found a strong interaction with period of birth (p < 0.0001). CONCLUSIONS/INTERPRETATION The results obtained indicate that early-life factors linked to seasons may influence type 1 diabetes risk later in life.
Collapse
Affiliation(s)
- A M Vaiserman
- Laboratory of Mathematical Modelling of Ageing Processes, Institute of Gerontology, Vyshgorodskaya st. 67, Kiev 04114, Ukraine.
| | | | | | | | | | | | | |
Collapse
|
19
|
Vaiserman AM, Voitenko VP, Tron’ko ND, Kravchenko VI, Khalangot ND, Mekhova LV, Gur’yanov VG. Role of seasonal factors in pre-and postnatal ontogenesis in etiology of type 1 diabetes mellitus. Russ J Dev Biol 2006; 37:230-236. [DOI: 10.1134/s1062360406040047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2024]
|
20
|
Kotani Y, Yokota I, Kagami S, Amemiya S, Matsuura N, Sasaki N. Relatively small birth size and accelerated early growth of Japanese type 1 diabetic children with younger onset. Clin Pediatr Endocrinol 2006; 15:73-8. [PMID: 24790324 PMCID: PMC4004850 DOI: 10.1297/cpe.15.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2005] [Accepted: 02/07/2006] [Indexed: 11/04/2022] Open
Abstract
We investigated the changes of anthropometrical parameters in Japanese children with type 1 diabetes (T1DM) from birth to the onset of diabetes. One-hundred ninety-nine children (79 males and 120 females) diagnosed between 0-16 yr of age during the period between 1990 and 2003 were the subjects of this study. The subjects were categorized into 3 groups according to onset age (0-5 yr; n=74, 5-10 yr; n=61, 10-16 yr; n=64). At birth, the younger onset (<5) group had significant lower height and weight standard deviation score (SDS) compared with the older onset (5≤) group (p=0.01 and p=0.02, respectively). When the changes in height SDS from birth to onset were compared, height SDS at onset were significantly greater than those at birth in the younger onset group (p<0.001). However, no significant difference was observed in the other groups (p=0.95 and p=0.39). These results suggest that relatively small size at birth and accelerated growth after birth until the onset of diabetes may be a characteristic of Japanese T1DM children with younger onset and may further support the hypothesis that emphasizes accelerated growth and subsequent insulin resistance as a cause of earlier onset of T1DM.
Collapse
Affiliation(s)
- Yumiko Kotani
- Department of Pediatrics, Tokushima University Graduate
School of Medical Sciences, Tokushima, Japan
| | - Ichiro Yokota
- Department of Pediatrics, Tokushima University Graduate
School of Medical Sciences, Tokushima, Japan
| | - Shoji Kagami
- Department of Pediatrics, Tokushima University Graduate
School of Medical Sciences, Tokushima, Japan
| | - Shin Amemiya
- Department of Pediatrics, Saitama Medical College, Saitama,
Japan
| | - Nobuo Matsuura
- Department of Child Studies, Seitoku University Faculty of
Humanities, Matsudo, Japan
| | - Nozomu Sasaki
- Department of Pediatrics, Saitama Medical College, Saitama,
Japan
| | | |
Collapse
|
21
|
Mordes JP, Bortell R, Blankenhorn EP, Rossini AA, Greiner DL. Rat models of type 1 diabetes: genetics, environment, and autoimmunity. ILAR J 2005; 45:278-91. [PMID: 15229375 DOI: 10.1093/ilar.45.3.278] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
For many years, the vast amount of data gathered from analysis of nonobese diabetic (NOD) and congenic NOD mice has eclipsed interest in the rat for the study of type 1 diabetes. The study of rat models has continued, however, and recently there has been a reanimation of interest for several reasons. First, genetic analysis of the rat has accelerated. Ian4L1, cblb, and Iddm4 are now known to play major roles in rat autoimmunity. Second, rats are amenable to study the interactions of genetics and environment that may be critical for disease expression in humans. Environmental perturbants that predictably enhance the expression of rat autoimmune diabetes include viral infection, toll-like receptor ligation, and depletion of regulatory T cell populations. Finally, data generated in the rat have correctly predicted the outcome of several human diabetes prevention trials, notably the failure of nicotinamide and low dose parenteral and oral insulin therapies.
Collapse
Affiliation(s)
- John P Mordes
- Department of Medicine, University of Massachusetts, Medical School, Worcester, MA, USA
| | | | | | | | | |
Collapse
|
22
|
Hettiarachchi KD, Zimmet PZ, Myers MA. Transplacental exposure to bafilomycin disrupts pancreatic islet organogenesis and accelerates diabetes onset in NOD mice. J Autoimmun 2004; 22:287-96. [PMID: 15120752 DOI: 10.1016/j.jaut.2004.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Revised: 01/28/2004] [Accepted: 02/19/2004] [Indexed: 10/26/2022]
Abstract
Bafilomycin, a plecomacrolide produced by plant-pathogenic Streptomyces, contaminates tuberous vegetables and has adverse effects on beta cells in adult mice. We therefore determined whether dietary bafilomycin influenced the progression of diabetes in the non-obese diabetic (NOD) mouse model of autoimmune Type 1 diabetes. Parent NOD mice were fed sub-toxic doses of bafilomycin in drinking water from conception until weaning, or various times after birth and blood glucose was monitored in the offspring. Pancreatic islets in neonatal offspring were examined histologically by quantitative morphometry and islet cell apoptosis was estimated by TUNEL assay. Exposure in utero to bafilomycin but not after birth significantly accelerated onset and increased the frequency of diabetes. In exposed mice, pancreatic islet organogenesis was disrupted, characterized by a striking increase in beta-cell mass and a shift in timing of the normal wave of neonatal islet cell apoptosis from 2 weeks to 4 weeks of age. We postulate that accelerated onset and increased incidence of diabetes later in life result from disruption of the normal turnover of beta cells in the neonatal pancreas. Since bafilomycin and related plecomacrolides contaminate Streptomyces-infected vegetables, dietary exposure during pregnancy could be an important and previously unsuspected environmental component of human Type 1 diabetes.
Collapse
Affiliation(s)
- K D Hettiarachchi
- Department of Biochemistry and Molecular Biology, Monash University, Building 13D, Wellington Road, Clayton, Victoria 3800, Australia
| | | | | |
Collapse
|
23
|
Abstract
The concept of immunological tolerance is central to our understanding of type 1 diabetes and the development of strategies for its prediction, prevention, and cure. Tolerance simply refers to the absence of an immune response. Most of us are born with an immune system that develops tolerance to all the other systems of our bodies as well as to the things that we eat. It is the loss of immunological tolerance that leads to autoimmunity. And when that autoimmune response directly or indirectly targets the beta-cell, type 1 diabetes is the result. In the U.S., 1 in 600 of us loses tolerance to pancreatic beta-cells. Interference with T-cell function after the loss of tolerance, as can be achieved with immunosuppressive drugs like cyclosporin, arrests the disease, but the cost in side effects is high. Clearly, stopping the loss of tolerance would be preferable. If we can stop the loss of tolerance, we can prevent the disease. We and many others have investigated both approaches. But what of the people who already have diabetes? For them a separate but related strategy, tolerance induction, is required. Specifically, islet transplantation tolerance induction holds out the promise of being able to cure the disease. This has been the ultimate goal of our laboratory's work for the past two decades.
Collapse
Affiliation(s)
- Aldo A Rossini
- Diabetes Division, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
| |
Collapse
|
24
|
Peppa M, He C, Hattori M, McEvoy R, Zheng F, Vlassara H. Fetal or neonatal low-glycotoxin environment prevents autoimmune diabetes in NOD mice. Diabetes 2003; 52:1441-8. [PMID: 12765955 DOI: 10.2337/diabetes.52.6.1441] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Advanced glycation end products (AGEs) are implicated in beta-cell oxidant stress. Diet-derived AGE (dAGE) are shown to contribute to end-organ toxicity attributed to diabetes. To assess the role of dAGE on type 1 diabetes, NOD mice were exposed to a high-AGE diet (H-AGE) and to a nutritionally similar diet with approximate fivefold-lower levels of N(epsilon)-carboxymethyllysine (CML) and methylglyoxal-derivatives (MG) (L-AGE). Suppression of serum CML and MG in L-AGE-fed mice was marked by suppression of diabetes (H-AGE mice >94% vs. L-AGE mice 33% in founder [F](0), 14% in F(1), and 13% in F(2) offspring, P < 0.006) and by a delay in disease onset (4-month lag). Survival for L-AGE mice was 76 vs. 0% after 44 weeks of H-AGE mice. Reduced insulitis in L-AGE versus H-AGE mice (P < 0.01) was marked by GAD- and insulin-unresponsive pancreatic interleukin (IL)-4-positive CD4+ cells compared with the GAD- and insulin-responsive interferon (IFN)-gamma-positive T-cells from H-AGE mice (P < 0.005). Splenocytes from L-AGE mice consisted of GAD- and insulin-responsive IL-10-positive CD4+ cells compared with the IFN-gamma-positive T-cells from H-AGE mice (P < 0.005). Therefore, high AGE intake may provide excess antigenic stimulus for T-cell-mediated diabetes or direct beta-cell injury in NOD mice; both processes are ameliorated by maternal or neonatal exposure to L-AGE nutrition.
Collapse
Affiliation(s)
- Melpomeni Peppa
- Division of Experimental Diabetes and Aging, Department of Geriatrics, Mount Sinai School of Medicine, Box 1640, New York, NY 10029, USA.
| | | | | | | | | | | |
Collapse
|