The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update
Marian Rewers, Heikki Hyöty, Åke Lernmark, William Hagopian, Jin-Xiong She, Desmond Schatz, Anette-G Ziegler, Jorma Toppari, Beena Akolkar, Jeffrey Krischer, TEDDY Study Group, Marian Rewers, Kimberly Bautista, Judith Baxter, Daniel Felipe-Morales, Kimberly Driscoll, Brigitte I Frohnert, Marisa Gallant, Patricia Gesualdo, Michelle Hoffman, Rachel Karban, Edwin Liu, Jill Norris, Adela Samper-Imaz, Andrea Steck, Kathleen Waugh, Hali Wright, Jorma Toppari, Olli G Simell, Annika Adamsson, Suvi Ahonen, Heikki Hyöty, Jorma Ilonen, Sanna Jokipuu, Leena Karlsson, Miia Kähönenμ, Mikael Knip, Mirva Koreasalo, Kalle Kurppa, Tiina Latva-Ahoμ, Maria Lönnrot, Markus Mattila, Elina Mäntymäki, Katja Multasuoμ, Tiina Niininen, Sari Niinistö, Mia Nyblom, Sami Oikarinen, Paula Ollikainenμ, Petra Rajala, Jenna Rautanen, Anne Riikonen, Minna Romo, Suvi Ruohonen, Juulia Rönkäμ, Satu Simell, Tuula Simell, Maija Sjöberg, Aino Steniusμ, Sini Vainionpää, Eeva Varjonen, Riitta Veijola, Suvi M Virtanen, Mari Vähä-Mäkilä, Mari Åkerlund, Katri Lindfors, Jin-Xiong She, Desmond Schatz, Diane Hopkins, Leigh Steed, Jennifer Bryant, Janey Adams, Katherine Silvis, Michael Haller, Melissa Gardiner, Richard McIndoe, Ashok Sharma, Stephen W Anderson, Laura Jacobsen, John Marks, Anette G Ziegler, Andreas Beyerlein, Ezio Bonifacio, Anita Gavrisan, Cigdem Gezginci, Anja Heublein, Michael Hummel, Sandra Hummel, Andrea Keimer, Annette Knopff, Charlotte Koch, Sibylle Koletzko, Claudia Ramminger, Roswith Roth, Marlon Scholz, Joanna Stock, Katharina Warncke, Lorena Wendel, Christiane Winkler, Åke Lernmark, Daniel Agardh, Carin Andrén Aronsson, Maria Ask, Jenny Bremer, Ulla-Marie Carlsson, Corrado Cilio, Emelie Ericson-Hallström, Annika Fors, Lina Fransson, Thomas Gard, Rasmus Bennet, Carina Hansson, Susanne Hyberg, Hanna Jisser, Fredrik Johansen, Berglind Jonsdottir, Silvija Jovic, Helena Elding Larsson, Marielle Lindström, Markus Lundgren, Maria Månsson-Martinez, Maria Markan, Jessica Melin, Zeliha Mestan, Caroline Nilsson, Karin Ottosson, Kobra Rahmati, Anita Ramelius, Falastin Salami, Sara Sibthorpe, Anette Sjöberg, Birgitta Sjöberg, Carina Törn, Anne Wallin, Åsa Wimar, Sofie Åberg, William A Hagopian, Michael Killian, Claire Cowen Crouch, Jennifer Skidmore, Ashley Akramoff, Jana Banjanin, Masumeh Chavoshi, Kayleen Dunson, Rachel Hervey, Rachel Lyons, Arlene Meyer, Denise Mulenga, Jared Radtke, Davey Schmitt, Julie Schwabe, Sarah Zink, Dorothy Becker, Margaret Franciscus, MaryEllen Dalmagro-Elias Smith, Ashi Daftary, Mary Beth Klein, Chrystal Yates, Jeffrey P Krischer, Sarah Austin-Gonzalez, Maryouri Avendano, Sandra Baethke, Rasheedah Brown, Brant Burkhardt, Martha Butterworth, Joanna Clasen, David Cuthbertson, Christopher Eberhard, Steven Fiske, Dena Garcia, Jennifer Garmeson, Veena Gowda, Kathleen Heyman, Belinda Hsiao, Francisco Perez Laras, Hye-Seung Lee, Shu Liu, Xiang Liu, Kristian Lynch, Colleen Maguire, Jamie Malloy, Cristina McCarthy, Aubrie Merrell, Steven Meulemans, Hemang Parikh, Ryan Quigley, Cassandra Remedios, Chris Shaffer, Laura Smith, Susan Smith, Noah Sulman, Roy Tamura, Ulla Uusitalo, Kendra Vehik, Ponni Vijayakandipan, Keith Wood, Jimin Yang, Michael Abbondondolo, Lori Ballard, David Hadley, Wendy McLeod, Beena Akolkar, Kasia Bourcier, Thomas Briese, Suzanne Bennett Johnson, Eric Triplett, Liping Yu, Dongmei Miao, Polly Bingley, Alistair Williams, Kyla Chandler, Olivia Ball, Ilana Kelland, Sian Grace, Ben Gillard, Elisabeth Aardal Eriksson, Ing-Marie Lundgren, Ewa Lönn Karlsson, Dzeneta Nezirevic Dernroth, Iris Erlund, Irma Salminen, Jouko Sundvall, Nina Kangas, Petra Arohonka, Randie R Little, Curt Rohlfing, William Hagopian, Henry Erlich, Steven J Mack, Anna Lisa Fear, Oliver Fiehn, Bill Wikoff, Brian Defelice, Dmitry Grapov, Tobias Kind, Mine Palazoglu, Luis Valdiviez, Benjamin Wancewicz, Gert Wohlgemuth, Joyce Wong, Joseph F Petrosino, Nadim J Ajami, Richard E Lloyd, Matthew C Ross, Jacqueline L O'Brien, Diane S Hutchinson, Daniel P Smith, Matthew C Wong, Xianjun Tian, Tulin Ayvaz, Auriole Tamegnon, Nguyen Truong, Hannah Moreno, Lauren Riley, Eduardo Moreno, Tonya Bauch, Lenka Kusic, Ginger Metcalf, Donna Muzny, HarshaVArdhan Doddapaneni, Richard Gibbs, Santica M Marcovina, Vinod P Gaur, Richard D Smith, Thomas O Metz, Charles Ansong, Bobbie-Jo Webb-Robertson, Hugh D Mitchell, Ernesto S Nakayasu, Wei-Jun Qian, Sandra Ke, Niveen Mulholland, Haitao Liu, John Nechtman, Yansheng Zhao, Na Jiang, Yanna Tian, Guangkuo Dong, Stephen S Rich, Wei-Min Chen, Suna Onengut-Gumuscu, Emily Farber, Rebecca Roche Pickin, Jonathan Davis, Jordan Davis, Dan Gallo, Jessica Bonnie, Paul Campolieto, William E Winter, David L Pittman, Marian Rewers, Heikki Hyöty, Åke Lernmark, William Hagopian, Jin-Xiong She, Desmond Schatz, Anette-G Ziegler, Jorma Toppari, Beena Akolkar, Jeffrey Krischer, TEDDY Study Group, Marian Rewers, Kimberly Bautista, Judith Baxter, Daniel Felipe-Morales, Kimberly Driscoll, Brigitte I Frohnert, Marisa Gallant, Patricia Gesualdo, Michelle Hoffman, Rachel Karban, Edwin Liu, Jill Norris, Adela Samper-Imaz, Andrea Steck, Kathleen Waugh, Hali Wright, Jorma Toppari, Olli G Simell, Annika Adamsson, Suvi Ahonen, Heikki Hyöty, Jorma Ilonen, Sanna Jokipuu, Leena Karlsson, Miia Kähönenμ, Mikael Knip, Mirva Koreasalo, Kalle Kurppa, Tiina Latva-Ahoμ, Maria Lönnrot, Markus Mattila, Elina Mäntymäki, Katja Multasuoμ, Tiina Niininen, Sari Niinistö, Mia Nyblom, Sami Oikarinen, Paula Ollikainenμ, Petra Rajala, Jenna Rautanen, Anne Riikonen, Minna Romo, Suvi Ruohonen, Juulia Rönkäμ, Satu Simell, Tuula Simell, Maija Sjöberg, Aino Steniusμ, Sini Vainionpää, Eeva Varjonen, Riitta Veijola, Suvi M Virtanen, Mari Vähä-Mäkilä, Mari Åkerlund, Katri Lindfors, Jin-Xiong She, Desmond Schatz, Diane Hopkins, Leigh Steed, Jennifer Bryant, Janey Adams, Katherine Silvis, Michael Haller, Melissa Gardiner, Richard McIndoe, Ashok Sharma, Stephen W Anderson, Laura Jacobsen, John Marks, Anette G Ziegler, Andreas Beyerlein, Ezio Bonifacio, Anita Gavrisan, Cigdem Gezginci, Anja Heublein, Michael Hummel, Sandra Hummel, Andrea Keimer, Annette Knopff, Charlotte Koch, Sibylle Koletzko, Claudia Ramminger, Roswith Roth, Marlon Scholz, Joanna Stock, Katharina Warncke, Lorena Wendel, Christiane Winkler, Åke Lernmark, Daniel Agardh, Carin Andrén Aronsson, Maria Ask, Jenny Bremer, Ulla-Marie Carlsson, Corrado Cilio, Emelie Ericson-Hallström, Annika Fors, Lina Fransson, Thomas Gard, Rasmus Bennet, Carina Hansson, Susanne Hyberg, Hanna Jisser, Fredrik Johansen, Berglind Jonsdottir, Silvija Jovic, Helena Elding Larsson, Marielle Lindström, Markus Lundgren, Maria Månsson-Martinez, Maria Markan, Jessica Melin, Zeliha Mestan, Caroline Nilsson, Karin Ottosson, Kobra Rahmati, Anita Ramelius, Falastin Salami, Sara Sibthorpe, Anette Sjöberg, Birgitta Sjöberg, Carina Törn, Anne Wallin, Åsa Wimar, Sofie Åberg, William A Hagopian, Michael Killian, Claire Cowen Crouch, Jennifer Skidmore, Ashley Akramoff, Jana Banjanin, Masumeh Chavoshi, Kayleen Dunson, Rachel Hervey, Rachel Lyons, Arlene Meyer, Denise Mulenga, Jared Radtke, Davey Schmitt, Julie Schwabe, Sarah Zink, Dorothy Becker, Margaret Franciscus, MaryEllen Dalmagro-Elias Smith, Ashi Daftary, Mary Beth Klein, Chrystal Yates, Jeffrey P Krischer, Sarah Austin-Gonzalez, Maryouri Avendano, Sandra Baethke, Rasheedah Brown, Brant Burkhardt, Martha Butterworth, Joanna Clasen, David Cuthbertson, Christopher Eberhard, Steven Fiske, Dena Garcia, Jennifer Garmeson, Veena Gowda, Kathleen Heyman, Belinda Hsiao, Francisco Perez Laras, Hye-Seung Lee, Shu Liu, Xiang Liu, Kristian Lynch, Colleen Maguire, Jamie Malloy, Cristina McCarthy, Aubrie Merrell, Steven Meulemans, Hemang Parikh, Ryan Quigley, Cassandra Remedios, Chris Shaffer, Laura Smith, Susan Smith, Noah Sulman, Roy Tamura, Ulla Uusitalo, Kendra Vehik, Ponni Vijayakandipan, Keith Wood, Jimin Yang, Michael Abbondondolo, Lori Ballard, David Hadley, Wendy McLeod, Beena Akolkar, Kasia Bourcier, Thomas Briese, Suzanne Bennett Johnson, Eric Triplett, Liping Yu, Dongmei Miao, Polly Bingley, Alistair Williams, Kyla Chandler, Olivia Ball, Ilana Kelland, Sian Grace, Ben Gillard, Elisabeth Aardal Eriksson, Ing-Marie Lundgren, Ewa Lönn Karlsson, Dzeneta Nezirevic Dernroth, Iris Erlund, Irma Salminen, Jouko Sundvall, Nina Kangas, Petra Arohonka, Randie R Little, Curt Rohlfing, William Hagopian, Henry Erlich, Steven J Mack, Anna Lisa Fear, Oliver Fiehn, Bill Wikoff, Brian Defelice, Dmitry Grapov, Tobias Kind, Mine Palazoglu, Luis Valdiviez, Benjamin Wancewicz, Gert Wohlgemuth, Joyce Wong, Joseph F Petrosino, Nadim J Ajami, Richard E Lloyd, Matthew C Ross, Jacqueline L O'Brien, Diane S Hutchinson, Daniel P Smith, Matthew C Wong, Xianjun Tian, Tulin Ayvaz, Auriole Tamegnon, Nguyen Truong, Hannah Moreno, Lauren Riley, Eduardo Moreno, Tonya Bauch, Lenka Kusic, Ginger Metcalf, Donna Muzny, HarshaVArdhan Doddapaneni, Richard Gibbs, Santica M Marcovina, Vinod P Gaur, Richard D Smith, Thomas O Metz, Charles Ansong, Bobbie-Jo Webb-Robertson, Hugh D Mitchell, Ernesto S Nakayasu, Wei-Jun Qian, Sandra Ke, Niveen Mulholland, Haitao Liu, John Nechtman, Yansheng Zhao, Na Jiang, Yanna Tian, Guangkuo Dong, Stephen S Rich, Wei-Min Chen, Suna Onengut-Gumuscu, Emily Farber, Rebecca Roche Pickin, Jonathan Davis, Jordan Davis, Dan Gallo, Jessica Bonnie, Paul Campolieto, William E Winter, David L Pittman
Abstract
Purpose of review: The environmental triggers of islet autoimmunity leading to type 1 diabetes (T1D) need to be elucidated to inform primary prevention. The Environmental Determinants of Diabetes in the Young (TEDDY) Study follows from birth 8676 children with T1D risk HLA-DR-DQ genotypes in the USA, Finland, Germany, and Sweden. Most study participants (89%) have no first-degree relative with T1D. The primary outcomes include the appearance of one or more persistent islet autoantibodies (islet autoimmunity, IA) and clinical T1D.
Recent findings: As of February 28, 2018, 769 children had developed IA and 310 have progressed to T1D. Secondary outcomes include celiac disease and autoimmune thyroid disease. While the follow-up continues, TEDDY has already evaluated a number of candidate environmental triggers, including infections, probiotics, micronutrient, and microbiome. TEDDY results suggest that there are multiple pathways leading to the destruction of pancreatic beta-cells. Ongoing measurements of further specific exposures, gene variants, and gene-environment interactions and detailed "omics" studies will provide novel information on the pathogenesis of T1D.
Keywords: Autoimmunity; Children; Type 1 diabetes.
Conflict of interest statement
Conflict of Interest Marian Rewers, William Hagopian, Jin-Xiong She, Desmond Schatz, Anette-G Ziegler, Beena Akolkar, and Jeffrey Krischer declare that they have no conflict of interest.
Heikki Hyöty reports grants from National Institute of Health (NIH) to carry out the TEDDY study; and being a Shareholder and member of the board of Vactech Ltd., which develops vaccines against picornaviruses.
Ake Lernmark is a Member of the Scientific Advisory Board of Diamyd Medical AB, Stockholm, Sweden.
Jorma Toppari reports grants from NIH/NIDDK.
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Source: PubMed