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Clean environment link to diabetes offers vaccine hope

Children who remained unaffected by diabetes had a greater diversity of intestinal bacteria than the ones who will go on to develop the disease. Image: Shutterstock
Children who remained unaffected by diabetes had a greater diversity of intestinal bacteria than the ones who will go on to develop the disease. Image: Shutterstock

Parents may one day feed high-strength bacteria to their kids in order to stop them from developing early onset diabetes, after research showed that over-hygienic environments are leading to a rise in incidences of the disease.

It’s the result of a study spanning one of the steepest contrasts in living standards in the world - the Finnish-Russian border where Finns are seven times wealthier than their neighbours in the Russian Karelia region.

The EU-funded DIABIMMUNE study focussed on an apparent paradox – despite the wealth gap, Finland has the highest levels of so-called Type 1 diabetes in the world, while Russian Karelia has significantly lower levels of development and hygiene, but also one-sixth of the cases of diabetes.

Currently, 17 000 Europeans are diagnosed with Type 1 diabetes each year. The disease, which is normally diagnosed during childhood, causes the body to start destroying its own insulin-producing cells in the pancreas, with the result that it cannot control the level of glucose in the blood.

While scientists do not yet know the precise cause of the disease, researchers now believe it may be more likely in children who have a genetic predisposition and whose immune systems haven’t been properly trained – by exposure to bacteria.

The Russia-Finland border is the perfect place to study this theory because the similarities of the populations means that genetic differences are minimised, which helps to highlight the effect of environmental and lifestyle factors.

Living standards

‘There is not a lot of difference in predisposing genotypes but there is a conspicuous difference in standard of living and standard of hygiene,’ said DIABIMMUNE coordinator Professor Mikael Knip. ‘The difference is stronger on this border than the difference between Mexico and the US.’

The difference in the standard of living between Russia and Finland is stronger than the difference between Mexico and the USThe difference in the standard of living between Russia and Finland is stronger than the difference between Mexico and the US.

The research was divided into two strands. In the first, researchers gathered information about the environment and physical development of between 100 and 300 babies with genetic susceptibility to autoimmunity in each country, from the time of their birth until the age of three. In the second, they collected data on a randomly-selected group of children from three to five years old.

Because the symptoms of diabetes can take years to appear, the researchers used biomarkers – biological early warning signs – to detect if the disease was developing.

Results indicated that the children who remained unaffected by Type 1 diabetes had a greater diversity of intestinal bacteria than the ones who will go on to develop the disease.

‘Our preliminary findings are along the hypothesis that you need microbial exposure early in life,’ said Prof. Knip. ‘If we can show that we need a certain exposure to microbes, we should be looking for interventions.’

One year

While the EU portion of the funding ended at the start of this year, the researchers are still finalising the field work. Within the next 12 months they hope to have identified whether it is one specific microbe, or the total diversity of microbes in the gut that plays a preventative role, and be able to recommend actions.

‘We can use safe microbes to train the immune system,’ Prof. Knip said. ‘Probiotics are being used now but they are likely too mild; we need more stimulating microbes.’

Asthma, dermatitis

The contrast between Finland and Russian Karelia has also been studied by researchers on another EU-funded project, MeDALL, which looks at the mechanisms involved in the onset of allergies and allergy-related conditions such as asthma and dermatitis.

The study, which investigated exactly how the environment interacts with genes to produce a higher level of allergies in Finland than in Russian Karelia, is just one part of the MeDALL project, which brings together international researchers to forge a better understanding of how genetic and environmental factors combine to lead to allergies.

Researchers hope to discover new biological indicators that will help to diagnose allergies earlier, as well as identify new targets for therapy.

For details, visit http://medall-fp7.eu/

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