Viruses Were Not Associated With Rapid-Onset T1d In One Group Of Children

Viruses are a potential cause of the T1D disease process in individuals who are genetically susceptible. To test this possibility, the authors of this study assumed that children in the TEDDY study* with a rapid onset of T1D may have been exposed to viruses shortly before the initiation of autoimmunity and thus studying these children may help identify viruses involved in the development of T1D. They searched for viruses in plasma samples and examined the history of infection and fever in children enrolled in the TEDDY study who progressed to T1D within 6 months from the appearance of autoimmunity markers and they also looked in a similar group that did not develop T1D (the control group). In this study viruses were not detected more frequently in the blood from children with rapid-onset T1D than in controls. In addition, infection histories were found to be similar between children with rapid-onset diabetes and control children, although episodes of fever were reported less frequently in children with rapid-onset diabetes.

*TEDDY: The Environmental Determinants of Diabetes in the Young. The primary objective(s) of this multi-center, multi-national, epidemiological study (a birth cohort) is identification of infectious agents, dietary factors, or other environmental exposures that are associated with increased risk of autoimmunity and T1DM. Factors affecting specific manifestations such as early age of onset or rate of progression, or with protection from the development of T1DM will also be identified.

Ramifications for Individuals with T1D:

One focus of the JDRF research portfolio is the Prevention of T1D – stopping it before an individual becomes dependent on insulin. JDRF is funding efforts that aim to understand the biological processes that occur very early on in the disease process, with special emphasis on the interaction between genetic predisposition and environmental triggers. The earliest collected bio-samples of the TEDDY study participants allow for some of these questions to be addressed and this pilot project addressed a long standing question on the role of viruses in triggering T1D. Although the findings of this study are negative, this is an important result that cannot by itself rule in or rule out a critical role of viruses in T1D etiology. Results from other sample sets will be needed with consistent findings to corroborate this result before we can make definitive statements about the role of viruses in T1D.

JDRF Involvement:

While this study was funded exclusively by the TEDDY funds, JDRF scientific staff maintains close ties with the TEDDY effort and participate in the group’s calls and steering committee meetings. Extensive studies are underway to investigate the presence of viruses in the entire TEDDY study cohort, results of which should be forthcoming in the next couple of years. JDRF will closely monitor these efforts and will take advantage of any opportunity to engage in efforts that may complement their efforts to speed evaluation of potential prevention strategies.

Investigators and Institutions:

Lee HS, Briese T, Winkler C, Rewers M, Bonifacio E, Hyoty H, Pflueger M, Simell O, She JX, Hagopian W, Lernmark A, Akolkar B, Krischer JP, Ziegler AG; the TEDDY study group.

Reference:

Lee HS, Briese T, and others. Next-generation sequencing for viruses in children with rapid-onset type 1 diabetes.

Diabetologia. 2013 Aug;56(8):1705-11. doi: 10.1007/s00125-013-2924-y. Epub 2013 May 9.