The cross-border initiative focused on defence against diabetes

Monday, 23 June, 2014
Type 1 diabetes results from abnormal activity of the body's immune system and it is on the rise in European children and adolescents. A European research project aims to find out why the cleanliness long assumed to be the best defence against this disease could actually be the cause of it.
The project, DIABIMMUNE, was prompted by a Nordic mystery: why is it that Finland – which has some of the highest living standards and healthcare in the world – also has the highest incidence of diabetes in the world? And why are infection rates six times lower across the border in Karelia in north-western Russia, where living standards are much lower than the European average? The research, which included input from Karelia’s Petrozavodsk State University, came to the counter-intuitive conclusion that the answer hides in something medicine usually considers its enemies: antigens such as microbes, viruses, fungi and dust particles.The good news is that feeding mothers do help their babies develop a stronger immunity.

Project coordinator Mikael Knip, a professor at the Children’s Hospital University of Helsinki, Finland, explains his hygiene hypothesis as the idea that lack of infections in early life can lead to a dysfunctional immune system, favouring allergic and autoimmune diseases. “We asked the question whether the total microbial load over the first years of life is critical for programming (building up) the immune system or whether specific microbes play a crucial programming role,” he says.

The DIABIMMUNE research team examined infection rates in Finland, Estonia and Russia, studying 4,500 children under the age of five. “So far we have seen clear differences in the frequency of early signs of autoimmunity and allergy among the three countries involved,” Knip says.

One of the international project partners, Natalya Dorshakova, a medical science professor at Petrozavodsk State University in Karelia, was involved in finding and transporting biological samples to the core laboratory in Helsinki. She says that the “fanatical fight against microbes” has weakened the body’s defences. “We install multiple window glazing against street dust, we use products for the body and home with strong disinfectant additives, the food industry uses antibiotics, etc,” she explains.

Dorshakova says the research under the DIABIMMUNE project has already had some success in treating diabetes and dealing with its symptoms and complications. However, the aim is to prevent the start of the autoimmune process. This is best done through an early “acquaintance” with antigens such as microbes, viruses, fungi and dust particles. “It is essential for newborns to develop and build up immunity,” she says. “If the body overcomes the initial exposure to a particular antigen and gains immunity, then the next encounter will be peaceful and stress-free,” adds Dorshakova.

DIABIMMUNE also found significant differences in the frequency of various viral infections among the three countries. In addition, less-desired immune responses are suppressed more powerfully in Estonian infants compared to Finnish peers.

“We have collected a unique biobank with a diverse series of biological samples to be analysed over the years to come,” explains Knip, pointing out that it could lead to a treatment for allergic and autoimmune diseases. “If we can develop an effective preventive treatment for allergic and autoimmune diseases, that would raise the quality of life for a considerable proportion of the European population and would also lower the future healthcare costs for the society,” he says.

Pathogenesis of type 1 Diabetes - testing the hygiene hypothesis
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