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Johansen VBI, Josefsen K, Antvorskov JC. The Impact of Dietary Factors during Pregnancy on the Development of Islet Autoimmunity and Type 1 Diabetes: A Systematic Literature Review. Nutrients 2023; 15:4333. [PMID: 37892409 PMCID: PMC10609322 DOI: 10.3390/nu15204333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
AIMS AND HYPOTHESIS The incidence of type 1 diabetes mellitus in children is considerably increasing in western countries. Thus, identification of the environmental determinants involved could ultimately lead to disease prevention. Here, we aimed to systematically review (PROSPERO ID: CRD42022362522) the current evidence of the association between maternal dietary factors during gestation and the risk of developing type 1 diabetes and/or islet autoimmunity (IA) in murine and human offspring. METHODS In accordance with PRISMA guidelines, the present systematic review searched PubMed and Scopus (n = 343) for different combinations of MeSH terms, such as type 1 diabetes, diet, islet autoimmunity, prenatal, nutrient, gluten, gliadin, vitamin, milk, and fibers. RESULTS We found that the most investigated dietary factors in the present literature were gluten, dietary advanced glycosylated end products (dAGEs), vitamin D, fatty acids, and iron. The results concerning prenatal exposure to a gluten-free environment showed a consistently protective effect on the development of IA. Prenatal exposures to vitamin D and certain fatty acids appeared to protect against the development of IA, whereas in utero iron and fat exposures correlated with increased risks of IA. CONCLUSION We conclude that a definite association is not established for most factors investigated as the literature represents a heterogeneous pool of data, although fetal exposures to some maternal dietary components, such as gluten, show consistent associations with increased risks of IA. We suggest that human prospective dietary intervention studies in both cohort and clinical settings are crucial to better evaluate critical and protective prenatal exposures from the maternal diet during pregnancy.
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Affiliation(s)
- Valdemar Brimnes Ingemann Johansen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
- Department of Biology, Faculty of Science, University of Copenhagen, Ole Maaløes Vej 5, 2200 Copenhagen, Denmark
- Department of Pathology, The Bartholin Institute, Rigshospitalet, Copenhagen Biocenter, Ole Maaløes Vej 5, 2200 Copenhagen, Denmark; (K.J.); (J.C.A.)
| | - Knud Josefsen
- Department of Pathology, The Bartholin Institute, Rigshospitalet, Copenhagen Biocenter, Ole Maaløes Vej 5, 2200 Copenhagen, Denmark; (K.J.); (J.C.A.)
| | - Julie Christine Antvorskov
- Department of Pathology, The Bartholin Institute, Rigshospitalet, Copenhagen Biocenter, Ole Maaløes Vej 5, 2200 Copenhagen, Denmark; (K.J.); (J.C.A.)
- Steno Diabetes Center, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
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Prescott S, Mutka T, Baumgartel K, Yoo JY, Morgan H, Postolache TT, Seyfang A, Gostner JM, Fuchs D, Kim K, Groer ME. Tryptophan metabolism and immune alterations in pregnant Hispanic women with chronic Toxoplasma gondii infection. Am J Reprod Immunol 2023; 90:e13768. [PMID: 37641377 PMCID: PMC10538252 DOI: 10.1111/aji.13768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/18/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023] Open
Abstract
PROBLEM Pregnancy markedly modifies women's metabolism and immune functions. We hypothesized that pregnancy might alter the immune and metabolic responses to chronic Toxoplasma gondii infection in pregnancy. METHOD OF STUDY A population of 690 pregnant Hispanic women were screened for antibodies to T. gondii and 158 women were positive (23% positivity) with 83% showing high avidity indices. These seropositive women were followed through their pregnancies with four data collection time points and a postpartum collection at two clinics in Tampa, Florida. A T. gondii seronegative group (N = 128) was randomly selected to serve as a control group and measured along pregnancy in the same way. Serum levels of tryptophan, kynurenine, and their ratio, phenylalanine, tyrosine and their ratio, neopterin, and nitrite were measured through pregnancy and the postpartum. A plasma cytokine panel (IFN-γ, TNFα, IL-2, IL-10, IL-12, IL-6, IL-17) was analyzed in parallel. RESULTS The major findings suggest that indoleamine 2,3-dioxygenase (IDO-1) was less activated in T. gondii seropositive pregnant Hispanic women with chronic infection. Evidence for IDO-1 suppression was that tryptophan catabolism was less pronounced and there were lower levels of multiple inflammatory cytokines including IFN-γ, which is the major inducer of IDO-1, and higher nitrite concentration, a surrogate marker for nitric oxide, an inhibitor of IDO. CONCLUSIONS Latent T. gondii infection was associated with higher plasma tryptophan levels, and lower inflammatory cytokines across pregnancy, suggesting suppression of the IDO-1 enzyme, and possible T cell exhaustion during pregnancy.
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Affiliation(s)
- Stephanie Prescott
- University of South Florida, College of Nursing, Tampa, Florida, USA
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Tina Mutka
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Kelley Baumgartel
- University of South Florida, College of Nursing, Tampa, Florida, USA
| | - Ji Youn Yoo
- University of Tennessee, College of Nursing, Knoxville, Tennessee, USA
| | - Hailey Morgan
- University of South Florida, College of Nursing, Tampa, Florida, USA
| | - Teodor T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Rocky Mountain MIRECC for Suicide Prevention, Aurora, Colorado, USA
- VISN 5 MIRECC, Baltimore, Maryland, USA
| | - Andreas Seyfang
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Johanna M Gostner
- Institute of Medical Biochemistry, Medical University of Innsbruck, Austria
| | - Dietmar Fuchs
- Institute of Biological Chemistry, Medical University of Innsbruck, Austria
| | - Kami Kim
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Maureen E Groer
- University of Tennessee, College of Nursing, Knoxville, Tennessee, USA
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Jul Clemmensen P, Brix N, Schullehner J, Lunddorf LLH, Ernst A, Ebdrup NH, Bjerregaard AA, Hansen B, Thomas Stayner L, Ingi Halldorsson T, Frodi Olsen S, Sigsgaard T, Kolstad HA, Ramlau-Hansen CH. Prenatal nitrate exposure from diet and drinking water and timing of puberty in sons and daughters: A nationwide cohort study. ENVIRONMENT INTERNATIONAL 2022; 170:107659. [PMID: 36651653 DOI: 10.1016/j.envint.2022.107659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/31/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In Western countries, age at pubertal development has declined during the last century in girls, and probably also in boys. No studies have investigated whether nitrate, a widespread environmental exposure with teratogenic and hormone disrupting properties, might affect timing of puberty. OBJECTIVES We investigated if prenatal exposure to nitrate from drinking water and diet was associated with timing of puberty. METHODS This cohort study included 15,819 children born from 2000 to 2003 within the Danish National Birth Cohort. Self-reported information on current status of various pubertal milestones was provided every six months by a questionnaire from 11 years of age until 18 years or full maturity, whichever came first. Maternal nitrate intake from diet (mg/day) was derived from a mid-pregnancy food frequency questionnaire and individual level nitrate exposure from drinking water (mg/L) was derived using measurements from Danish public waterworks. Adjusted average differences in months in age at attaining several pubertal milestones as well as the average age difference in age at attaining all the milestones were estimated separately for diet and water using a regression model for interval-censored data. C- and E-vitamin, red meat and processed meat intake were explored as potential effect modifiers in sub-analyses. RESULTS No strong associations were observed between prenatal exposure to nitrate and timing of puberty in children. However, sons born of mothers with a nitrate concentration in drinking water at their residential address of > 25 mg/L (half of the World Health Organisation (WHO) guideline value) compared with ≤ 1 mg/L showed a tendency towards earlier age at pubertal development with an average age difference of -1.2 months (95 % confidence interval,-3.0;0.6) for all the pubertal milestones combined. DISCUSSION Studies including more highly exposed children are needed before the current WHO drinking water guideline value for nitrate can be considered safe concerning pubertal development.
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Affiliation(s)
| | - Nis Brix
- Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Jörg Schullehner
- Department of Public Health, Aarhus University, Aarhus, Denmark; Geological Survey of Denmark and Greenland, Aarhus, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
| | | | - Andreas Ernst
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ninna Hinchely Ebdrup
- Department of Public Health, Aarhus University, Aarhus, Denmark; Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
| | - Anne Ahrendt Bjerregaard
- Department of Epidemiology Research, Center for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark; Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Leslie Thomas Stayner
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, United States
| | - Thorhallur Ingi Halldorsson
- Department of Epidemiology Research, Center for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark; Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Iceland
| | - Sjurdur Frodi Olsen
- Department of Epidemiology Research, Center for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark; Section of Epidemiology, Institute of Public Health, University of Copenhagen, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Aarhus University, Aarhus, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark; Cirrau -Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Perna-Barrull D, Murillo M, Real N, Gomez-Muñoz L, Rodriguez-Fernandez S, Bel J, Puig-Domingo M, Vives-Pi M. Prenatal Betamethasone Exposure and its Impact on Pediatric Type 1 Diabetes Mellitus: A Preliminary Study in a Spanish Cohort. J Diabetes Res 2022; 2022:6598600. [PMID: 35308094 PMCID: PMC8930272 DOI: 10.1155/2022/6598600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/24/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Betamethasone, a glucocorticoid used to induce lung maturation when there is a risk of preterm delivery, can affect the immune system maturation and type 1 diabetes (T1D) incidence in the progeny. It has been described that prenatal betamethasone protects offspring from experimental T1D development. The main aim of this study was to evaluate the possible association between betamethasone prenatal exposure and T1D in humans. Research Design and Methods. A retrospective case-control study with a total of 945 children, including 471 patients with T1D and 474 healthy siblings, was performed. Participants were volunteers from the Germans Trias i Pujol Hospital and DiabetesCero Foundation. Parents of children enrolled in the study completed a questionnaire that included questions about weeks of gestation, preterm delivery risk, weight at birth, and prenatal betamethasone exposure of their children. Multiple logistic regression was used to detect the association between betamethasone exposure and T1D. RESULTS We compared T1D prevalence between subjects prenatally exposed or unexposed to betamethasone. The percent of children with T1D in the exposed group was 37.5% (21 of 56), and in the unexposed group was 49.52% (410 of 828) (p = 0.139). The percentage of betamethasone-treated subjects with T1D in the preterm group (18.05%, 13 of 72) was significantly higher than that found in the control group (12.5%, 9 of 72) (p = 0.003). The odds ratio for T1D associated with betamethasone in the univariate logistic regression was 0.59 (95% confidence interval, 0.33; 1.03 [p = 0.062]) and in the multivariate logistic regression was 0.83 (95% confidence interval, 0.45; 1.52 [p = 0.389]). CONCLUSIONS The results demonstrate that the prenatal exposure to betamethasone does not increase T1D susceptibility, and may even be associated with a trend towards decreased risk of developing the disease. These preliminary findings require further prospective studies with clinical data to confirm betamethasone exposure effect on T1D risk.
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Affiliation(s)
- David Perna-Barrull
- Immunology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Marta Murillo
- Pediatrics Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Nati Real
- Pediatrics Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Laia Gomez-Muñoz
- Immunology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Silvia Rodriguez-Fernandez
- Immunology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Joan Bel
- Pediatrics Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Manel Puig-Domingo
- Endocrinology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
| | - Marta Vives-Pi
- Immunology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain
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Sabella FM, de Feiria SNB, Ribeiro ADA, Theodoro LH, Höfling JF, Parisotto TM, Duque C. Exploring the Interplay Between Oral Diseases, Microbiome, and Chronic Diseases Driven by Metabolic Dysfunction in Childhood. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.718441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Oral childhood diseases, such as caries and gingivitis, have much more than a local impact on the dentition and tooth surrounding tissues, which can affect systemic conditions. While the mouth is frequently exposed to microbial stressors that can contribute to an inflammatory state in the entire body, chronic disorders can also interfere with oral health. Sharing common risk factors, a dynamic interplay can be driven between 1. dental caries, gingivitis, and type I diabetes mellitus, 2. early childhood caries and obesity, and 3. caries and cardiovascular diseases. Considering that there are ~2.2 billion children worldwide and that childhood provides unique opportunities for intervention targeting future health promotion, this review is of prime importance and aimed to explore the relationship between the oral microbiome and oral chronic diseases driven by metabolic dysfunction in childhood.
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