Early probiotic use may decrease risk of islet autoimmunity in children at risk for type 1 diabetes

The University of South Florida played a coordinating role in the international TEDDY study

Tampa, FL (Nov. 9, 2015) — Probiotic exposure during the first 27 days of an infant’s life may be associated with reduced risk of islet autoimmunity among children at increased genetic risk for type 1 diabetes, although further studies are needed before any recommendations for probiotics can be made, according to a University of South Florida-led study published online by JAMA Pediatrics.

Probiotics are live organisms that may confer health benefits. Animal studies have looked at manipulation of gut microbiota by probiotics and the risk of developing type 1 diabetes (T1DM) related to autoimmunity.

Ulla Uusitalo, PhD, of the University of South Florida, and coauthors examined the association between supplemental probiotic use during the first year of life and islet autoimmunity. Islet autoimmunity occurs when antibodies attacks islet cells in the pancreas that produce insulin. The condition, which precedes the symptoms of type 1 diabetes, can be detected by measuring these islet autoantibodies in the blood.

“We have taken a baby step forward, and there is the possibility that in the future we may find preventive measures for Type 1 diabetes using probiotics, among children at high risk,” said Dr. Uusitalo, associate professor of pediatrics at the USF Health Morsani College of Medicine.

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Ulla Uusitalo, PhD, associate professor of pediatrics based at the USF Health Informatics Institute, was lead author of the international study on probiotics and islet autoimmunity.

Dr. Uusitalo and colleagues report the results of The Environmental Determinants of Diabetes in the Young (TEDDY) study, which started in 2004 with children from six clinical centers, three in the United States (Colorado, Georgia/Florida and Washington) and three in Europe (Finland, Germany and Sweden).

The children were followed-up for T1DM-related autoantibodies with blood samples drawn every three months between 3 and 48 months of age and every six months thereafter to determine persistent islet autoimmunity. Questionnaires and diaries were used to detail infant feeding, including probiotic supplementation and infant formula use.

A final study sample consisted of 7,473 children who ranged in age from 4 to 10 years old. Probiotic supplementation from dietary supplements or infant formula varied by country and was most pervasive in Finland and Germany during the first year of a child’s life.

Receiving probiotics through a dietary supplement or fortified infant formula, or both, by 27 days of age may be associated with a reduced risk of islet autoimmunity compared with those children who first received probiotics after 27 days of age or not at all. Early probiotic exposure appeared to be associated with a 60-percent decrease in the risk of islet autoimmunity among children with the highest-risk HLA genotype DR3/4 but not among other genotypes.

An association does not imply causality and further research needs to be done, the authors note.

“Early exposure to supplemental probiotics may decrease the risk of IA [islet autoimmunity] among children at elevated risk of T1DM. … These results have to be confirmed before making recommendations on the use of probiotic supplementation,” the study concludes.

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Infants in the study received probiotics through a dietary supplement of oral drops or fortified infant formula,

The probiotics and islet autoimmunity study is one of many overseen by the Data Coordinating Center of the University of South Florida’s Health Informatics Institute led by Dr. Jeffrey Krischer, Distinguished University Health Professor. The center coordinates, analyzes and maintains research data from several large clinical networks investigating the causes and outcomes of type 1 diabetes, including TEDDY, TrialNet, TRIGR and DPT-1.

This NIH-supported hub also maintains a communication network to enhance collaboration and pooling of data among researchers across the world. Professionals in data management, software developing, biostatistics, epidemiology, psychology, nutrition, and other life sciences work seamlessly as a team, seeking to understand the triggers of type 1 diabetes and related autoimmune diseases and to develop strategies for prevention or improved treatment.

Article citation:

Ulla Uusitalo, PhD; Xiang Liu, PhD; Jimin Yang, PhD, RD: Carin Andren Aronsson, MS; Sandra Hummel, PhD; Martha Butterworth, MS; Ake Lernmark, PhD: William Hogopian, MD, PhD; Jin-Xiong She, PhD;  Olli Simell, MD, PhD; Jorma Toppari, MD, PhD; Anette G. Ziegler, PhD; Beena Akolkar, PhD; Jeffrey Krischer, PhD; Jill M. Norris, PhD; Suvi M. Virtanen, MD, PhD; for the TEDDY Study Group. “Association of Early Exposure of Probiotics and Islet Autoimmunity in the TEDDY Study,”  JAMA Pediatrics. Published online November 9, 2015. doi:10.1001/jamapediatrics.2015.2757.

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Video and photos by Sandra C. Roa, USF Health Marketing & Communications