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Is the origin of type 1 diabetes in the gut?
Immunol Cell Biol. 2012 Mar; 90(3):271-6.IC

Abstract

In type 1 diabetes, insulin-producing beta-cells in the pancreas are destroyed by immune-mediated mechanisms. The manifestation of the disease is preceded by the so-called pre-diabetic period that may last several years and is characterized by the appearance of circulating autoantibodies against beta-cell antigens. The role of the gut as a regulator of type 1 diabetes was suggested in animal studies, in which changes affecting the gut immune system modulated the incidence of diabetes. Dietary interventions, alterations in the intestinal microbiota and exposure to enteric pathogens, regulate the development of autoimmune diabetes in animal models. It has been demonstrated that these modulations affect the gut barrier mechanisms and intestinal immunity. Because the pancreas and the gut belong to the same intestinal immune system, the link between autoimmune diabetes and the gut is not unexpected. The gut hypothesis in the development of type 1 diabetes is also supported by the observations made in human type 1 diabetes. Early diet could modulate the development of beta-cell autoimmunity; weaning to hydrolysed casein formula decreased the risk of beta-cell autoimmunity by age 10 in the infants at genetic risk. Increased gut permeability, intestinal inflammation with impaired regulatory mechanisms and dysregulated oral tolerance have been observed in children with type 1 diabetes. The factors that contribute to these intestinal alterations are not known, but interest is focused on the microbial stimuli and function of innate immunity. It is likely that our microbial environment does not support the healthy maturation of the gut and tolerance in the gut, and this leads to the increasing type 1 diabetes as well as other immune-mediated diseases regulated by intestinal immune system. Thus, the interventions, aiming to prevent or treat type 1 diabetes in humans, should be targeting the gut immune system.

Authors+Show Affiliations

Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland. outi.vaarala@thl.fi

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22290506

Citation

Vaarala, Outi. "Is the Origin of Type 1 Diabetes in the Gut?" Immunology and Cell Biology, vol. 90, no. 3, 2012, pp. 271-6.
Vaarala O. Is the origin of type 1 diabetes in the gut? Immunol Cell Biol. 2012;90(3):271-6.
Vaarala, O. (2012). Is the origin of type 1 diabetes in the gut? Immunology and Cell Biology, 90(3), 271-6. https://doi.org/10.1038/icb.2011.115
Vaarala O. Is the Origin of Type 1 Diabetes in the Gut. Immunol Cell Biol. 2012;90(3):271-6. PubMed PMID: 22290506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is the origin of type 1 diabetes in the gut? A1 - Vaarala,Outi, Y1 - 2012/01/31/ PY - 2012/2/1/entrez PY - 2012/2/1/pubmed PY - 2012/8/15/medline SP - 271 EP - 6 JF - Immunology and cell biology JO - Immunol. Cell Biol. VL - 90 IS - 3 N2 - In type 1 diabetes, insulin-producing beta-cells in the pancreas are destroyed by immune-mediated mechanisms. The manifestation of the disease is preceded by the so-called pre-diabetic period that may last several years and is characterized by the appearance of circulating autoantibodies against beta-cell antigens. The role of the gut as a regulator of type 1 diabetes was suggested in animal studies, in which changes affecting the gut immune system modulated the incidence of diabetes. Dietary interventions, alterations in the intestinal microbiota and exposure to enteric pathogens, regulate the development of autoimmune diabetes in animal models. It has been demonstrated that these modulations affect the gut barrier mechanisms and intestinal immunity. Because the pancreas and the gut belong to the same intestinal immune system, the link between autoimmune diabetes and the gut is not unexpected. The gut hypothesis in the development of type 1 diabetes is also supported by the observations made in human type 1 diabetes. Early diet could modulate the development of beta-cell autoimmunity; weaning to hydrolysed casein formula decreased the risk of beta-cell autoimmunity by age 10 in the infants at genetic risk. Increased gut permeability, intestinal inflammation with impaired regulatory mechanisms and dysregulated oral tolerance have been observed in children with type 1 diabetes. The factors that contribute to these intestinal alterations are not known, but interest is focused on the microbial stimuli and function of innate immunity. It is likely that our microbial environment does not support the healthy maturation of the gut and tolerance in the gut, and this leads to the increasing type 1 diabetes as well as other immune-mediated diseases regulated by intestinal immune system. Thus, the interventions, aiming to prevent or treat type 1 diabetes in humans, should be targeting the gut immune system. SN - 1440-1711 UR - https://www.unboundmedicine.com/medline/citation/22290506/Is_the_origin_of_type_1_diabetes_in_the_gut L2 - https://doi.org/10.1038/icb.2011.115 DB - PRIME DP - Unbound Medicine ER -