Children at Risk for Type 1 Diabetes May Benefit from Early Probiotic Use

Children at Risk for Type 1 Diabetes May Benefit from Early Probiotic Use

A recent study published in the JAMA Pediatrics journal revealed that exposure to probiotics during the first 27 days in the life of an infant with increased genetic risk for type 1 diabetes is associated with a reduction in the risk of islet autoimmunity, meaning the production of autoantibodies that can destroy insulin-producing beta cells in the islets of the pancreas. However, the research team is cautious and advises that more research is necessary before any recommendations for probiotics can be made. The study is entitled Association of Early Exposure of Probiotics and Islet Autoimmunity in the TEDDY study.

The newborn’s immune system needs to quickly learn how to tolerate beneficial bacteria and defend against opportunistic pathogens. The intestinal microbiota can influence the balance between pro-inflammatory and regulatory immune responses. But there are still unanswered questions as to how the immune system interacts with the microbiota.

Probiotics (live bacteria and yeasts that offer health benefits) are hypothesized to affect the immunological responses to environmental exposures by supporting healthy gut microbiota, and could therefore theoretically be used to prevent the development of type 1 diabetes mellitus (T1DM)–associated islet autoimmunity.

The Environmental Determinants of Diabetes in the Young (TEDDY) is an ongoing, longitudinal, multinational study started in 2004, investigating the effect of probiotics on children with genetically increased risk for T1DM across six clinical centers in Colorado, Washington, and Georgia in the United States, and also in Germany, Sweden and Finland.

All children in the TEDDY study were followed-up for T1DM-related autoantibodies, with blood samples drawn every three months between 3 and 48 months of age, and every six months thereafter to determine persistent islet autoimmunity. To detail infant feeding, including probiotic supplementation and infant formula, researchers used diaries and questionnaires.

Now, using data from the TEDDY study, researchers looked at the association between supplemental probiotic use during the first year of life and islet autoimmunity in a population of 7,473 children (on Oct. 31, 2014, the age range of these children was 4 to 10 years).

The results from the study revealed a reduction in the risk of islet autoimmunity in children who had received dietary supplements of probiotics at or before age 27 days in comparison to those who first received probiotics after 27 days of life.

“Early exposure to supplemental probiotics may decrease the risk of IA [islet autoimmunity] among children at elevated risk of T1DM. … These results have to be confirmed before making recommendations on the use of probiotic supplementation,” concluded the research team according to a recent news release.

In a related editorial, George M. Weinstock, PhD, of the Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, wrote: “This protective association between early probiotic use and T1DM-related IA awaits further randomized clinical trials. … While probiotic use in children is not that common in the United States, statistics in the current study show it to be more widespread in the study’s other participating sites of Finland, Germany and Sweden. This is an area in its infancy but likely to have a large impact on the medicine of the future.”

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