This article is more than 5 years old. Information may no longer be current.
Antibiotic use in early life unrelated to type 1 diabetes, celiac disease
Click Here to Manage Email Alerts
The use of beta-lactam or macrolide antibiotics in young children who are genetically at risk for type 1 diabetes or celiac disease before seroconversion was not linked to the future risk of celiac disease autoimmunity or type 1 diabetes, according to a study published in JAMA Pediatrics.
“The increasing use of antibiotics worldwide has been proposed as a cause for the growing incidence of autoimmune diseases in industrialized countries, particularly type 1 diabetes and celiac disease,” Kaisa M. Kemppainen, PhD, from the department of microbiology and cell science in the Institute of Food and Agricultural Sciences at the University of Florida, and colleagues wrote. “The presence or absence of an association between antibiotic use and autoimmune diseases could have profound influences on future antibiotic use worldwide.”
To examine the connection between antibiotic use in early life and islet or celiac disease autoimmunity in children who were genetically at risk for the conditions, as well as to prospectively follow up on these children for type 1 diabetes or celiac disease, the researchers conducted a study that included HLA-genotyped newborns from Finland, Germany, Sweden and the United States.
All infants included were placed in birth cohorts between Nov. 20, 2004, and Aug. 31, 2014, and had a first-degree relative with type 1 diabetes, as well as one of nine HLA genotypes associated with type 1 diabetes. The use of cephalosporins, penicillins and macrolides between the ages of 3 months and 4 years was reported by parents. Infants were considered to have islet autoimmunity or celiac disease autoimmunity if they tested positive for islet or tissue transglutaminase.
The two cohorts from the TEDDY study included 8,495 infants (49.0% female) and 6,558 infants (48.7% female). The first cohort was tested for islet autoantibodies, and the second was examined for tissue transglutaminase autoantibodies. Increased risk of islet autoimmunity or celiac disease autoimmunity was not associated with antibiotic use or the frequency of antibiotic use in this study.
Additionally, cumulative antibiotic doses within the first 4 years of life were not linked to any autoantibody (HR, 0.98; 95% CI, 0.95-1.01), multiple islet autoantibodies (HR, 0.99; 95% CI, 0.95-1.03) or transglutaminase autoantibodies (HR, 1.00; 95% CI, 0.98-1.02).
“Recently, no association between reported bacterial infectious episodes and islet autoimmunity or celiac disease autoimmunity risk was demonstrated in the first 4 years of life in the TEDDY cohort, consistent with the observation herein that antibiotic use also did not influence the risk of autoimmunity,” Kemppainen and colleagues wrote. “Meanwhile, evidence is mounting for a role of viral infections in the etiology of type 1 diabetes and celiac disease in the TEDDY study, with gastrointestinal and respiratory infections associated with an increased risk of celiac disease autoimmunity and islet autoimmunity, respectively.” – by Katherine Bortz
Disclosure: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts