PMID- 30338642
OWN - NLM
STAT- MEDLINE
DCOM- 20190819
LR  - 20190819
IS  - 1399-5448 (Electronic)
IS  - 1399-543X (Linking)
VI  - 20
IP  - 1
DP  - 2019 Feb
TI  - Early childhood CMV infection may decelerate the progression to clinical type 1 
      diabetes.
PG  - 73-77
LID - 10.1111/pedi.12788 [doi]
AB  - 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.
CI  - (c) 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Ekman, Ilse
AU  - Ekman I
AUID- ORCID: 0000-0003-4711-5086
AD  - Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, 
      Finland.
AD  - Department of Clinical Microbiology, University of Eastern Finland, Kuopio, 
      Finland.
FAU - Vuorinen, Tytti
AU  - Vuorinen T
AD  - Department of Virology, University of Turku and Turku University Hospital, Turku, 
      Finland.
FAU - Knip, Mikael
AU  - Knip M
AUID- ORCID: 0000-0003-0474-0033
AD  - Children's Hospital, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
AD  - Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, 
      Finland.
AD  - Center for Child Health Research, Tampere University Hospital, Tampere, Finland.
AD  - Folkhalsan Research Center, Helsinki, Finland.
FAU - Veijola, Riitta
AU  - Veijola R
AD  - Department of Pediatrics, Medical Research Center, PEDEGO Research Unit, 
      University of Oulu and Oulu University Hospital, Oulu, Finland.
FAU - Toppari, Jorma
AU  - Toppari J
AD  - Institute of Biomedicine, University of Turku, Turku, Finland.
AD  - Department of Pediatrics, University of Turku and Turku University hospital, 
      Turku, Finland.
FAU - Hyoty, Heikki
AU  - Hyoty H
AD  - Department of Virology, University of Tampere, Tampere, Finland.
AD  - Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland.
FAU - Kinnunen, Tuure
AU  - Kinnunen T
AD  - Department of Clinical Microbiology, University of Eastern Finland, Kuopio, 
      Finland.
AD  - Eastern Finland Laboratory Centre (ISLAB), Kuopio, Finland.
FAU - Ilonen, Jorma
AU  - Ilonen J
AUID- ORCID: 0000-0002-9973-2062
AD  - Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, 
      Finland.
AD  - Clinical Microbiology, Turku University Hospital, Turku, Finland.
FAU - Lempainen, Johanna
AU  - Lempainen J
AD  - Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, 
      Finland.
AD  - Department of Pediatrics, University of Turku and Turku University hospital, 
      Turku, Finland.
LA  - eng
GR  - Emil Aaltonen Foundation/International
GR  - JDRF/Juvenile Diabetes Research Foundation/United States
GR  - Sigrid Juselius Foundation/International
GR  - Academy of Finland/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181119
PL  - Denmark
TA  - Pediatr Diabetes
JT  - Pediatric diabetes
JID - 100939345
RN  - 0 (Autoantibodies)
RN  - 0 (HLA-DQ Antigens)
MH  - Adolescent
MH  - Age of Onset
MH  - Autoantibodies/blood
MH  - Autoimmunity/physiology
MH  - Child
MH  - Child, Preschool
MH  - Cytomegalovirus/immunology
MH  - Cytomegalovirus Infections/complications/*epidemiology/immunology
MH  - Diabetes Mellitus, Type 1/*epidemiology/genetics/immunology/*pathology
MH  - Disease Progression
MH  - Female
MH  - Finland/epidemiology
MH  - Follow-Up Studies
MH  - Genetic Predisposition to Disease
MH  - HLA-DQ Antigens/genetics
MH  - Humans
MH  - Infant
MH  - Islets of Langerhans/immunology
MH  - Male
MH  - Risk Factors
OTO - NOTNLM
OT  - CMV
OT  - autoantibodies
OT  - cytomegalovirus
OT  - type 1 diabetes
EDAT- 2018/10/20 06:00
MHDA- 2019/08/20 06:00
CRDT- 2018/10/20 06:00
PHST- 2018/06/01 00:00 [received]
PHST- 2018/09/15 00:00 [revised]
PHST- 2018/09/25 00:00 [accepted]
PHST- 2018/10/20 06:00 [pubmed]
PHST- 2019/08/20 06:00 [medline]
PHST- 2018/10/20 06:00 [entrez]
AID - 10.1111/pedi.12788 [doi]
PST - ppublish
SO  - Pediatr Diabetes. 2019 Feb;20(1):73-77. doi: 10.1111/pedi.12788. Epub 2018 Nov 
      19.