Erschienen in:
01.12.2018 | Pathogenesis of Type 1 Diabetes (A Pugliese and SJ Richardson, Section Editors)
The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update
verfasst von:
Marian Rewers, Heikki Hyöty, Åke Lernmark, William Hagopian, Jin-Xiong She, Desmond Schatz, Anette-G Ziegler, Jorma Toppari, Beena Akolkar, Jeffrey Krischer, the TEDDY Study Group
Erschienen in:
Current Diabetes Reports
|
Ausgabe 12/2018
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Abstract
Purpose of Review
The environmental triggers of islet autoimmunity leading to type 1 diabetes (T1D) need to be elucidated to inform primary prevention. The Environmental Determinants of Diabetes in the Young (TEDDY) Study follows from birth 8676 children with T1D risk HLA-DR-DQ genotypes in the USA, Finland, Germany, and Sweden. Most study participants (89%) have no first-degree relative with T1D. The primary outcomes include the appearance of one or more persistent islet autoantibodies (islet autoimmunity, IA) and clinical T1D.
Recent Findings
As of February 28, 2018, 769 children had developed IA and 310 have progressed to T1D. Secondary outcomes include celiac disease and autoimmune thyroid disease. While the follow-up continues, TEDDY has already evaluated a number of candidate environmental triggers, including infections, probiotics, micronutrient, and microbiome.
Summary
TEDDY results suggest that there are multiple pathways leading to the destruction of pancreatic beta-cells. Ongoing measurements of further specific exposures, gene variants, and gene-environment interactions and detailed “omics” studies will provide novel information on the pathogenesis of T1D.