November 17, 2015
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Early probiotic exposure may decrease islet autoimmunity risk in children

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Among children at the highest genetic risk for type 1 diabetes, early probiotic supplementation may reduce the risk for islet autoimmunity, according to recent study findings published in JAMA Pediatrics.

Ulla Uusitalo, PhD, of the University of South Florida, and colleagues evaluated data from the TEDDY study on 7,473 children aged 4 to 10 years to determine the association between supplemental probiotic use during the first year of life and islet autoimmunity.

Researchers found a decreased risk for islet autoimmunity among participants exposed to probiotics during the first 27 days of life (n = 540; HR = 0.66; 95% CI, 0.45-0.96) compared with exposure after 27 days or no exposure, even after adjustment for first-degree relative status (P < .001), HLA-DR-DQ genotype (P < .001), sex (P = .006), birth order (P = .15) and mode of delivery (P = .46).

A strong inverse relationship was found among participants with an HLA genotype of DR3/4 (HR = 0.4; 95% CI, 0.21-0.74) but not among other genotypes (HR = 0.97; 95% CI, 0.62-1.54) for early probiotic exposure and islet autoimmunity.

“Early exposure to supplemental probiotics may decrease the risk of [islet autoimmunity] among children at elevated risk of [type 1 diabetes],” the researchers wrote. “However, a randomized clinical trial should confirm the association, and mechanistic analyses are needed to identify potential environmental factors (eg, infections that could mediate the association). These results have to be confirmed before making recommendations to the use of probiotic supplementation.”

In an accompanying editorial, George M. Weinstock, PhD, of The Jackson Laboratory for Genomic Medicine in Farmington, Connecticut, wrote that the findings had a significantly measureable effect.

“This raises the questions of whether there are better bacterial strains for the prevention of [type 1 diabetes] and whether the current general-purpose organisms could be of benefit for other diseases, which in turn could have their own optimally protective organisms,” Weinstock wrote. – by Amber Cox

Disclosure: The researchers and Weinstock report no relevant financial disclosures.