University of Oulu

Ekman, I, Vuorinen, T, Knip, M, et al. Early childhood CMV infection may decelerate the progression to clinical type 1 diabetes. Pediatr Diabetes. 2019; 20: 73– 77. https://doi.org/10.1111/pedi.12788

Early childhood CMV infection may decelerate the progression to clinical type 1 diabetes

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Author: Ekman, Ilse1,2; Vuorinen, Tytti3; Knip, Mikael4,5,6,7;
Organizations: 1Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland
2Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
3Department of Virology, University of Turku and Turku University Hospital, Turku, Finland
4Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
6Center for Child Health Research, Tampere University Hospital, Tampere, Finland
7Folkhälsan Research Center, Helsinki, Finland
8Department of Pediatrics, Medical Research Center, PEDEGO Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
9Institute of Biomedicine, University of Turku, Turku, Finland
10Department of Pediatrics, University of Turku and Turku University hospital, Turku, Finland
11Department of Virology, University of Tampere, Tampere, Finland
12Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland
13Eastern Finland Laboratory Centre (ISLAB), Kuopio, Finland
14Clinical Microbiology, Turku University Hospital, Turku, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2019070522814
Language: English
Published: John Wiley & Sons, 2019
Publish Date: 2020-02-28
Description:

Abstract

Aims/Hypothesis: Evidence of the role of cytomegalovirus (CMV) infection in the pathogenesis of type 1 diabetes (T1D) has remained inconclusive. Our aim was to elucidate the possible role of CMV infection in the initiation of islet autoimmunity and in the progression to clinical T1D among children with human leukocyte antigen (HLA)‐conferred T1D risk.

Methods: A total of 1402 children from the prospective Type 1 Diabetes Prediction and Prevention (DIPP) study were analyzed for CMV‐specific IgG antibodies during early childhood. All the children carried HLA‐DQ genotypes associated with increased risk for T1D. The effect of CMV infection on the appearance of T1D‐associated autoantibodies (insulin autoantibodies [IAA], glutamic acid decarboxylase [GADA], and insulinoma antigen‐2 [IA‐2A], n = 356) and on the progression rate to clinical T1D (n = 233) were analyzed with Kaplan‐Meier survival analysis and Log‐rank test.

Results: Early childhood CMV infection was inversely associated with the development of T1D during childhood. Cumulative progression to T1D was decreased in subjects with an early CMV infection (P = 0.035). In further analyses, the effect of early CMV infection on the initiation of islet autoimmunity and progression to clinical T1D were examined separately. Interestingly, early CMV infection did not affect the appearance of T1D‐associated autoantibodies but a decelerating effect was observed on the progression rate from islet autoimmunity to clinical T1D (P = 0.015).

Conclusion: Our results suggest that an early childhood CMV infection may decelerate the progression from islet autoimmunity to clinical T1D among at‐risk children and may thus protect these children from progressing to T1D during childhood.

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Series: Pediatric diabetes
ISSN: 1399-543X
ISSN-E: 1399-5448
ISSN-L: 1399-543X
Volume: 20
Issue: 1
Pages: 73 - 77
DOI: 10.1111/pedi.12788
OADOI: https://oadoi.org/10.1111/pedi.12788
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
Subjects:
CMV
Funding: The study has been supported by the Academy of Finland, Sigrid Jusélius Foundation, Juvenile Diabetes Research Foundation, and Emil Aaltonen Foundation.
Copyright information: © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Ekman, I, Vuorinen, T, Knip, M, et al. Early childhood CMV infection may decelerate the progression to clinical type 1 diabetes. Pediatr Diabetes. 2019; 20: 73– 77. https://doi.org/10.1111/pedi.12788, which has been published in final form at https://doi.org/10.1111/pedi.12788. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.