IAA/GAD-positive offspring of diabetic parents have a different seasonality in month of birth than antibody-negative offspring

Hypothesis: Viral infections of pregnant women may be early triggers of childhood type 1 diabetes and other autoimmune disease

Children and adolescents with early onset autoimmune diseases have a different seasonality of month of birth than the general population. This pattern is consistent with an infection during pregnancy affecting the fetus or an infection immediately after birth that act as early triggers of the autoimmune diseases. We present data supporting the use of Rotavirus vaccinations in the reduction of incidence of childhood T1D and propose further investigations into whether other anti-virus vaccinations may reduce the burden of other autoimmune diseases such as multiple sclerosis, atopic dermatitis, psoriasis and subtypes of rheumatoid arthritis, Hashimoto thyroiditis.

Decrease in ATP biosynthesis and dysfunction of biological membranes. Two possible key mechanisms of phenoptosis

Metabolic syndrome is extremely prevalent in the world and can be considered as one of main factors leading to accelerated aging and premature death. This syndrome may be closely linked with age-related disruptions in hypothalamic-pituitary system function, which perhaps represent a trigger mechanism of development of endocrine and cardiovascular pathologies. Age-related elevation of the sensitivity threshold of the hypothalamus to regulatory signals in association with low mobility and excessive diet trigger a cascade of biochemical reactions that might be used for activation of programmed death of the organism - phenoptosis. Accumulation of fatty acids in a cell and resulting lipotoxicity include resistance to insulin and leptin, endoplasmic reticulum stress, uncoupling of oxidation and phosphorylation, and dysfunction of biological membranes. Decrease in ATP synthesis is correlated with accumulation of calcium ions in cells, dysfunction of mitochondria, and increasing apoptotic activity. Age-related activation of mTOR (which is greatly influenced by excess energy substrates) has deleterious impact on one of the main mechanisms of cell defense by which defective mitochondria are replaced: mitophagy and biogenesis of mitochondria will be suppressed, and this will increase in greater degree mitochondrial dysfunction and oxidative stress. Fatty acid-induced inflammation will increase activity of nuclear factor NF-κB, the well-known stimulator of age-related pathologies. The final stage of phenoptosis can be represented by endothelium dysfunction related with oxidative stress, insulin resistance, and the most prevalent cardiovascular pathologies.

Homocysteine induces procoagulant activity of red blood cells via phosphatidylserine exposure and microparticles generation

Increased homocysteine (Hcy) levels in plasma correlate with the risk of thromboic events. Red blood cells (RBCs), the most abundant blood cells in circulation, also play an active role in the process of thrombus formation. However, the effect of Hcy on procoagulant activity (PCA) of RBCs is unclear. In the present study, RBCs from healthy adults were treated with Hcy (8, 20, 80, 200, 800 μmol/L) for 24 h. Phosphatidylserine (PS) exposure of RBCs and red blood cell-derived microparticles (RMPs) release were detected using Alexa Fluor 488-lactadherin. PCA was assessed by coagulation time and purified clotting complexes testes. We found that Hcy treatment dose dependently enhanced PS exposure and consequent PCA of RBCs. Hcy also elevated the formation of procoagulant RMPs, with statistical significance at 800 μmol/L of Hcy. Moreover, 128 nmol/L lactadherin inhibited about 90% PCA of RBCs and RMPs. Our data suggest that PS exposure and RMPs shedding are key sources for Hcy-induced PCA of RBCs. Lactadherin could be used to modulate the anticoagulant and procoagulant balance in this process.

Seasonal variation of nutrient intake in pregnancy: effects on infant measures and possible influence on diseases related to season of birth

OBJECTIVES

To determine, firstly, if there was any seasonal effect on nutrient intake during pregnancy and birth measures, secondly, if there was any relationship between maternal nutrient intake and infant birth measures according to season and thirdly, to consider the hypothesis that seasonal change in nutrient intake during pregnancy might affect health in later life of some women's offspring.

DESIGN

Pilot study to determine number of days required to characterize group intake followed by a prospective cohort study.

SETTING

Patients attending a city ante-natal clinic in the lower North Island, New Zealand.

SUBJECTS

A total of 214 healthy mostly European pregnant women volunteers, entering the second trimester of pregnancy, of whom 10 miscarried and seven withdrew.

METHODS

Subjects were visited in months 4 and 7 of pregnancy, and months 2, 6 and 12 after birth. Height, weight and skinfolds were measured and questionnaires to determine personal details administered at these times. Subjects recorded 8 days of weighed diets in both the fourth and seventh month. Health records were used to supply infant measures.

RESULTS

Significant (P</=0.05) seasonal variations in fat, carbohydrate, vitamin C and D, B vitamins, beta-carotene, sodium, potassium, calcium, phosphorous, sulfur, sodium, chloride, zinc and selenium intakes were found. No significant 'main effect' difference in gestational age, infant birthweight, and head circumference was found with season. However, there were significant interactions (P</=0.05) for each birth season between birth measures and specific maternal nutrients at months 4 and 7 of pregnancy.

CONCLUSION

The significant seasonal variations in nutrient intake in pregnant women, and significant influence of nutrient intake on birth measures in different seasons, suggests seasonal nutrient variation may also affect fetal development at a cellular level. This supports our hypothesis that the development of conditions related to season of birth, including schizophrenia, multiple sclerosis, type I diabetes and longevity, may be influenced by seasonal variation in nutrient intake during pregnancy.

Autoimmunity and familial risk of type 1 diabetes

There is evidence that the process leading to type I diabetes may start in early infancy or already in utero. Even though diabetes-associated antibodies can be detected in up to half of the pregnancies of mothers with type I diabetes, pregnancy itself has no major effect on these antibodies. If such antibodies are present in the mother, they are transferred to the fetal circulation and are detectable in cord blood. Most of the transplacentally transferred antibodies disappear by 6 months of age, but may persist even longer. Antibodies present in cord blood may represent true induction of beta-cell autoimmunity, but such a phenomenon is extremely rare. The offspring of affected mothers have a 2% to 3% risk of type I diabetes, which is about one third of that in the offspring of affected fathers. A novel conceivable explanation is that exogenous insulin transplacentally transferred in immune complexes might lead to the induction of tolerance to insulin, which may be the primary autoantigen in type I diabetes. The possible protective or predisposing effect of diabetes-associated antibodies detectable at birth on progression to clinical type I diabetes later will be assessed in ongoing prospective birth cohort studies.