Medical Research: What is the background for this study? What are the main findings?
Dr. Uusitalo: The TEDDY Study is an international prospective cohort study with the primary goal to identify environmental causes of Type 1 Diabetes (T1D). It is carried out in six clinical research centers, in four countries: University of Colorado Health Science Center (US), Georgia Regents University (US), Pacific Northwest Diabetes Research Institute (US), Turku University Hospital (Finland), Institute of Diabetes Research (Germany), and Lund University (Sweden), since 2004.
One possible environmental factor related to Type 1 Diabetes etiology is diet. Dietary supplements including probiotics as well as various types of infant formulas including probiotic fortified infant formula are studied. The microbial composition of gut has been shown to be associated with the development of Type 1 Diabetes. Colonization of the infant gut starts already in utero and early microbial exposures have been found to be important in defining the trajectory of colonization. Probiotics have been demonstrated to induce favorable immunomodulation and it has been suggested that probiotic treatment could prevent T1D. Therefore we wanted to study the early exposures of probiotic and risk of islet autoimmunity, a condition often preceding Type 1 Diabetes.
This study produced very interesting results. The main finding was that we found 60% decrease in the risk of islet autoimmunity among children with HLA genotype of DR3/4 (high risk), who were exposed to probiotics during the first 27 days of life.
Medical Research: What should clinicians and patients take away from your report?
Dr. Uusitalo: It is too early to give any take-home messages based on this study. Studies have shown that administration of probiotics to children with healthy immune system is safe.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Uusitalo: It has been shown using animal models that oral probiotics are able to modify the composition of gut microbiota. Similar studies among humans are scarce. We need more studies in this area. If a randomized clinical trial would confirm the finding in TEDDY it would provide valuable evidence of causality between probiotics and islet autoimmunity. It would also be interesting to study if respiratory infections in young children could be prevented by probiotics. There is some evidence that these infections could be associated with islet autoimmunity.
Uusitalo U, Liu X, Yang J, et al. Association of Early Exposure of Probiotics and Islet Autoimmunity in the TEDDY Study. JAMA Pediatr. Published online November 09, 2015. doi:10.1001/jamapediatrics.2015.2757.
Dr. Ulla Uusitalo PhD (2015). Probiotics May Reduce Risk of Type 1 Diabetes