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SOURCE: VTT
Dec 16, 2008 08:06 ET
VTT
- New scientific knowledge on juvenile diabetes: Metabolic disturbances
indicate progress of the disease even years in advance
ESPOO, FINLAND--(Marketwire - December 16, 2008) -
Finnish
scientists have reported a breakthrough in the attempts to understand
the development of type 1 diabetes. They discovered disturbances in
lipid and amino acid metabolism in children who later progressed to
type 1 diabetes, also known as juvenile diabetes. The alterations
preceded the autoimmune response by months to years. The study may
prompt new approaches for prediction and prevention of type 1 diabetes
in pre-autoimmune phase of the disease.
The
results of the Finnish research team, which consists of scientists from
VTT Technical Research Centre of Finland and the Universities of Turku,
Oulu and Tampere, have been published on 15 December 2008, in the Journal of Experimental Medicine.
Type
1 diabetes is an autoimmune disease in which the immune system attacks
the insulin producing pancreatic beta cells. The gradual loss of beta
cells results in life-long dependence on exogenous insulin.
At
the moment, the earliest identifiable process in the pathogenesis of
type 1 diabetes has been the development of autoimmunity to pancreatic
beta cells in the measurable form of islet auto antibodies. Although
the autoimmunity usually precedes the clinical disease by months to
years, its occurrence may already be too late for therapeutic
approaches aimed at preventing progression to overt diabetes. The
initiators of the autoimmune response have remained unknown and the
mechanisms supporting progression towards beta cell failure have been
poorly understood, making discovery of effective prevention a
challenge. The results of the SYSDIPP project, which was supported by
the Tekes FinnWell Program, bring significant new information for
combating the disease.
The
SYSDIPP project has made use of metabolomics. Metabolomics
systematically studies the chemical fingerprints in cells, tissues and
biofluids in a given physiological and environmental context. The
metabolic phenotype is sensitive to subtle factors such as age,
lifestyle, nutrition and the microbe environment of the intestines.
Changes in the concentrations of metabolites may thus reflect both
genetic and environmental factors influencing later susceptibility to
chronic diseases.
In 1994, an ongoing birth cohort study (DIPP, the Type 1 Diabetes Prediction and Prevention study) was launched in Finland,
supported by the Juvenile Diabetes Research Foundation International.
Over a period of 14 years, more than 130,000 newborn infants have been
screened for genetic risk and over 8000 at-risk children are being
regularly followed.
The research team was led by Prof. Matej Oresic from VTT Technical Research Centre of Finland and Prof. Olli Simell from University of Turku.
Also Professors Mikael Knip, Jorma Ilonen, and Riitta Lahesmaa together
with Dr. Riitta Veijola and Dr.Tuula Simell took part in the study,
which investigated metabolic profiles of DIPP children prospectively
from birth. The research team has published the results in The Journal
of Experimental Medicine on 15 December 2008.
The article reports the discovery of metabolic disturbances that
precede the autoimmune response in children who later progress to type
1 diabetes.
The
investigators found that the individuals who developed diabetes had
reduced serum levels of succinic acid and phosphatidylcholine at birth,
reduced levels of triglycerides and antioxidant ether phospholipids
throughout the follow-up and increased levels of proinflammatory
lysophosphatidylcholines several months prior to autoimmunity to
pancreatic beta cells. The metabolic profile was partially normalized
following the autoimmune response, suggesting autoimmunity may be a
relatively late physiological response to the early metabolic
disturbances. The observed lipid changes were not attributable to
HLA-associated genetic risk.
Metabolic
profiling at early age may therefore aid in determining the risk of
type 1 diabetes. The reported findings imply that metabolic or
immunomodulatory interventions during the pre-autoimmune period may be
used as a new potential strategy for prevention of type 1 diabetes.
The
incidence of type 1 diabetes among children and adolescents has
increased markedly in the Western countries during recent decades. The
incidence has reached record levels in Finland,
where currently 1 child out of 120 develops type 1 diabetes before the
age of 15 years. The annual incidence is increasing at accelerated
rate, with the number of new cases expected to double in the next 15
years.