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https://hdl.handle.net/2440/119605
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Type: | Journal article |
Title: | Gut microbiome dysbiosis and increased intestinal permeability in children with islet autoimmunity and type 1 diabetes: a prospective cohort study |
Author: | Harbison, J.E. Roth-Schulze, A.J. Giles, L.C. Tran, C.D. Ngui, K.M. Penno, M.A. Thomson, R.L. Wentworth, J.M. Colman, P.G. Craig, M.E. Morahan, G. Papenfuss, A.T. Barry, S.C. Harrison, L.C. Couper, J.J. |
Citation: | Pediatric Diabetes, 2019; 20(5):574-583 |
Publisher: | Wiley Online Library |
Issue Date: | 2019 |
ISSN: | 1399-543X 1399-5448 |
Statement of Responsibility: | Lynne C. Giles, Cuong D. Tran ... Megan A. Penno, Rebecca L. Thomson ... Simon C Barry ... Jennifer J. Couper ... et al. |
Abstract: | AIMS/HYPOTHESIS:To investigate the longitudinal relationship between the gut microbiome, circulating short chain fatty acids (SCFAs) and intestinal permeability in children with islet autoimmunity or type 1 diabetes and controls. METHODS:We analyzed the gut bacterial microbiome, plasma SCFAs, small intestinal permeability and dietary intake in 47 children with islet autoimmunity or recent-onset type 1 diabetes and in 41 unrelated or sibling controls over a median (range) of 13 (2-34) months follow-up. RESULTS:Children with multiple islet autoantibodies (≥2 IA) or type 1 diabetes had gut microbiome dysbiosis. Anti-inflammatory Prevotella and Butyricimonas genera were less abundant and these changes were not explained by differences in diet. Small intestinal permeability measured by blood lactulose:rhamnose ratio was higher in type 1 diabetes. Children with ≥2 IA who progressed to type 1 diabetes (progressors), compared to those who did not progress, had higher intestinal permeability (mean [SE] difference +5.14 [2.0], 95% confidence interval [CI] 1.21, 9.07, P = .006), lower within-sample (alpha) microbial diversity (31.3 [11.2], 95% CI 9.3, 53.3, P = .005), and lower abundance of SCFA-producing bacteria. Alpha diversity (observed richness) correlated with plasma acetate levels in all groups combined (regression coefficient [SE] 0.57 [0.21], 95% CI 0.15, 0.99 P = .008). CONCLUSIONS/INTERPRETATION:Children with ≥2 IA who progress to diabetes, like those with recent-onset diabetes, have gut microbiome dysbiosis associated with increased intestinal permeability. Interventions that expand gut microbial diversity, in particular SCFA-producing bacteria, may have a role to decrease progression to diabetes in children at-risk. |
Keywords: | gut microbiome intestinal permeability islet autoimmunity short chain fatty acids type 1 diabetes |
Rights: | © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
DOI: | 10.1111/pedi.12865 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1111/pedi.12865 |
Appears in Collections: | Aurora harvest 4 Paediatrics publications |
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