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Type 1 diabetes is the most common metabolic disease in children and adolescents worldwide. This can be especially dangerous because often there is no diagnosis until severe and sometimes fatal symptoms have already developed. The new “SINT1A” study explores the potential of a specific probiotic to strengthen the immune system early in children with an increased genetic risk of type 1 diabetes, and thus prevent its development.
SINT1A is led by Helmholtz Zentrum Muenchen, and is part of the international GPPAD initiative comprising Professor Ezio Bonifacio and his team at the Center for Regenerative Therapies Dresden at TU Dresden.
About one in 300 children and adolescents is diagnosed with type 1 diabetes, an autoimmune disease, by the age of 18. About 90% of patients do not have a close relative with type 1 diabetes, which means the disease can affect any child without a history of the disease in their family.
People with type 1 diabetes have to inject the hormone insulin for the rest of their lives because their own immune system attacks the insulin-producing cells in the “islets” of their pancreas. Insulin has a vital function, carrying sugar from the blood to the cells of the body. The body’s own insulin is often the first target in the immune response that leads to type 1 diabetes.
Improving the immune system with probiotics At the onset of type 1 diabetes, so-called islet autoantibodies appear in the blood as a result of the immune system attacking insulin-producing cells. Researchers know from previous studies that children who develop these antibodies can suffer from imbalances in their gut flora in early childhood.
The new SINT1A study (B. infantis EVC001 supplementation) as well as their daily diet. It is believed that this promotes a healthy and balanced development of the intestinal flora, which would have beneficial effects on the immune system before the appearance of the first signs of autoimmunity.
SINT1A follows the ongoing Primary Oral Insulin Trial (POInT), which delivers insulin by mouth to train and sensitize the immune system at an early stage so that autoimmunity against insulin does not occur. not happen.
We believe that the immune system of the oral and intestinal mucosa is very important in preventing immune-mediated diseases like type 1 diabetes. The POInT study uses the gut (where oral insulin arrives) to familiarize the system. immune system with insulin and prevent an autoimmune response against it. SINT1A was designed based on the knowledge that a healthy gut microflora reduces inflammation and this helps the immune system better distinguish antigens that are safe from those that are dangerous. “
Prof. Ezio Bonifacio, Head of Study, TU Dresden
In this way, the SINT1A researchers want to reduce the chances that children with a high genetic risk of developing type 1 diabetes will start immune responses that lead to autoimmunity. “If the results of the two studies show what we hope”, explains Professor Bonifacio “we will aim to combine the two studies for an optimized synergistic strategy of prevention of type 1 diabetes. Type 1 diabetes could be transformed from a previously inevitable fate in a disease that can be avoided. “
The SINT1A study will begin in April 2021 in several European countries as part of GPPAD (Global Platform for the Prevention of Auto -immune Diabetes) – an international initiative for the prevention of type 1 diabetes. The GPPAD research sites are located in Belgium (Leuven), Germany (Dresden, Hanover, Munich), Poland (Warsaw), Sweden (Malmoe) and the United Kingdom (Cambridge, Newcastle).
Newborn screening for type 1 diabetes risk Participation in the SINT1A and POInT studies requires proof of an increased genetic risk for type 1 diabetes. Neonatal screening can detect this risk well before the onset of the disease. The test can be done with a few drops of blood in the first 7 days of life. Professor Bonifacio and his team launched a neonatal screening program for this purpose in 2016 (which is called “Freder1k” in Germany). “In collaboration with GPPAD’s strong scientific network, we were able to examine 245,000 babies during international newborn screening. In 1.15% we found an increased genetic risk. Early detection is imperative in order to take meaningful preventive measures, ”says Professor Reinhard Berner, director of the children’s hospital.
Research to prevent type 1 diabetes
The Leona M. and Harry B. Helmsley Charitable Trust is funding the new SINT1A study and further established newborn screening with more than US $ 30 million. “At Helmsley, we are committed to investing in bold ideas,” says Dr Anne Koralova, Program Officer at Helmsley. “GPPAD is one of our biggest investments because it shows great promise and represents the kind of international collaboration needed for scientific breakthroughs.”
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