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Disease-associated antibodies in offspring of mothers with IDDM.

Abstract

We studied 20 infants of mothers with IDDM participating in a pilot study for a dietary intervention trial, testing the hypothesis that avoidance of cow's milk proteins early in life will reduce the risk of subsequent IDDM. The aim was to evaluate the elimination of IDDM-associated antibodies from the peripheral circulation of the infants, the possible emergence of autoantibodies indicating beta-cell destruction, and the influence of the dietary intervention and genetic disease susceptibility on the development of these autoantibodies. Transplacentally transferred islet cell antibodies (ICAs) and antibodies to the 65-kDa isoform of glutamic acid decarboxylase (GAD65As) disappeared from the peripheral circulation of most infants over the first few months of life and in all infants before the age of 9 months. Insulin antibodies were eliminated before the same age in all cases but one. The higher the initial antibody level was, the longer the time required for elimination. Four infants tested positive for insulin autoantibodies (IAAs) on at least one occasion during the first year of life, and 5 out of 16 unaffected subjects (31%) had IAAs at the age of 2 years. One infant became positive for IAA before the age of 6 months, with increasing levels later, seroconverted to positivity for ICAs and GAD65As between 6 and 9 months and presented with clinical IDDM at the age of 14 months. He had the HLA DQB1*0302/x genotype, which predisposes carriers to IDDM, and had been given the casein hydrolysate formula as supplementary milk. There were no significant differences in the levels of various autoantibodies between two groups of subjects defined either on the type of dietary intervention or the degree of genetic susceptibility. The findings indicate that transplacentally transferred antibodies related to IDDM are usually eliminated from the peripheral circulation of infants before 9 months of age and that IDDM-associated autoantibodies may emerge before the age of 6 months. Our results also illustrate that avoidance of cow's milk proteins over the first 9 months of life does not provide total protection against IDDM.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, University of Oulu, Finland.

    , , , , , , ,

    Source

    Diabetes 45:12 1996 Dec pg 1706-10

    MeSH

    Adult
    Aging
    Autoantibodies
    Diabetes Mellitus, Type 1
    Female
    Genotype
    Glutamate Decarboxylase
    HLA-DQ Antigens
    HLA-DQ beta-Chains
    Humans
    Infant
    Infant Food
    Infant, Newborn
    Insulin
    Islets of Langerhans
    Male
    Maternal-Fetal Exchange
    Milk Proteins
    Pregnancy
    Risk Factors

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    8922355

    Citation

    Martikainen, A, et al. "Disease-associated Antibodies in Offspring of Mothers With IDDM." Diabetes, vol. 45, no. 12, 1996, pp. 1706-10.
    Martikainen A, Saukkonen T, Kulmala PK, et al. Disease-associated antibodies in offspring of mothers with IDDM. Diabetes. 1996;45(12):1706-10.
    Martikainen, A., Saukkonen, T., Kulmala, P. K., Reijonen, H., Ilonen, J., Teramo, K., ... Akerblom, H. K. (1996). Disease-associated antibodies in offspring of mothers with IDDM. Diabetes, 45(12), pp. 1706-10.
    Martikainen A, et al. Disease-associated Antibodies in Offspring of Mothers With IDDM. Diabetes. 1996;45(12):1706-10. PubMed PMID: 8922355.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Disease-associated antibodies in offspring of mothers with IDDM. AU - Martikainen,A, AU - Saukkonen,T, AU - Kulmala,P K, AU - Reijonen,H, AU - Ilonen,J, AU - Teramo,K, AU - Koskela,P, AU - Knip,M, AU - Akerblom,H K, PY - 1996/12/1/pubmed PY - 1996/12/1/medline PY - 1996/12/1/entrez SP - 1706 EP - 10 JF - Diabetes JO - Diabetes VL - 45 IS - 12 N2 - We studied 20 infants of mothers with IDDM participating in a pilot study for a dietary intervention trial, testing the hypothesis that avoidance of cow's milk proteins early in life will reduce the risk of subsequent IDDM. The aim was to evaluate the elimination of IDDM-associated antibodies from the peripheral circulation of the infants, the possible emergence of autoantibodies indicating beta-cell destruction, and the influence of the dietary intervention and genetic disease susceptibility on the development of these autoantibodies. Transplacentally transferred islet cell antibodies (ICAs) and antibodies to the 65-kDa isoform of glutamic acid decarboxylase (GAD65As) disappeared from the peripheral circulation of most infants over the first few months of life and in all infants before the age of 9 months. Insulin antibodies were eliminated before the same age in all cases but one. The higher the initial antibody level was, the longer the time required for elimination. Four infants tested positive for insulin autoantibodies (IAAs) on at least one occasion during the first year of life, and 5 out of 16 unaffected subjects (31%) had IAAs at the age of 2 years. One infant became positive for IAA before the age of 6 months, with increasing levels later, seroconverted to positivity for ICAs and GAD65As between 6 and 9 months and presented with clinical IDDM at the age of 14 months. He had the HLA DQB1*0302/x genotype, which predisposes carriers to IDDM, and had been given the casein hydrolysate formula as supplementary milk. There were no significant differences in the levels of various autoantibodies between two groups of subjects defined either on the type of dietary intervention or the degree of genetic susceptibility. The findings indicate that transplacentally transferred antibodies related to IDDM are usually eliminated from the peripheral circulation of infants before 9 months of age and that IDDM-associated autoantibodies may emerge before the age of 6 months. Our results also illustrate that avoidance of cow's milk proteins over the first 9 months of life does not provide total protection against IDDM. SN - 0012-1797 UR - https://www.unboundmedicine.com/medline/citation/8922355/Disease_associated_antibodies_in_offspring_of_mothers_with_IDDM_ L2 - http://diabetes.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=8922355 DB - PRIME DP - Unbound Medicine ER -