ImmuneDiabRisk - a study in the maturation of the immune system during pregnancy and in the early childhood
We and others have shown that perinatal factors influence the risk of developing Typ 1 Diabetes (T1D). It has been demonstrated that children from fathers have a higher risk to develop T1D as well as islet autoimmunity compared to children born to mothers with T1D. The maturation and development of the pancreas during pregnancy and during the first year of life seems to be faster and earlier in children of mothers with T1D. Probably, the maturation of the thymus of these children - as shown by ultrasound – is different. We hypothesize that children of mothers with T1D have a higher number of regulatory T-cells, a different cytokine profile, higher c-peptide and insulin-levels, but lower levels of proinsulin. Diabetes-specific autoantibodies are rare in these children compared to children who have a father or sibling with diabetes.
The aim of this study is to analyze differences in the maturation of the immune system and to identify mechanisms which can be used to prevent the development of autoimmunity. Pregnant women are invited to participate in the ImmuneDiabRisk study prior to week 20 of gestation. This includes pregnant women who have T1D, Type 2 diabetes, Gestational diabetes mellitus, MODY (Mature onset diabetes of the young) diabetes themselves as well as families with a relative who has T1D or families without any case of T1D. As the checkups take place mainly in Munich, we primarily address families in the Greater Munich area.
At week 20 and 28 of gestation, and at the age of two weeks, six months and twelve months postpartum, volume and size of the thymus and pancreas are assessed by ultrasound. Maternal blood samples are taken for DNA, RNA, PBMC, HbA1c and blood count measurements, and for storage. DNA, RNA and cells are collected, analysed and stored from the placenta after delivery. At birth, and three-monthly thereafter until the age of 24 months, blood samples are collected from the child for immediate T and B cell subset analysis, and for storage (DNA, RNA, PBMCs, blood count, plasma/serum). Demographic data and data on perinatal factors (C section, infections, medication, vaccinations, diet) will be analyzed using questionnaires. Stool samples are collected from the mother during pregnancy and from the child until the age of 24 months.
All pregnant women are invited to participate, whether they have type 1 diabetes or not. Participating women get two ultrasound investigations in a practice specialized for prenatal ultrasound as well as qualified and individual medical advice during the entire duration of the study.
Contact person: Dr. med. Katharina Warncke
Phone: 0800 / 8 28 48 68 (free hotline)
Email: prevent.diabetes@lrz.uni-muenchen.de