Department of Virology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Department of Internal Medicine, Tampere University Hospital, 33520, Tampere, Finland.
Diabetologia. 2018 Jan;61(1):203-209. doi: 10.1007/s00125-017-4410-4. Epub 2017 Sep 2.
AIMS/HYPOTHESIS: Animal and human studies have implied that enterovirus infections may modulate the risk of islet autoimmunity and type 1 diabetes. We set out to assess whether serial administration of live oral poliovirus vaccine (OPV) in early life can influence the initiation of islet autoimmunity in a cohort of genetically predisposed children.
OPV was administered to 64 children and a further 251 children received inactivated poliovirus vaccine (IPV). The emergence of type 1 diabetes-associated autoantibodies in serum (autoantibodies to GAD, insulinoma-associated protein 2, insulin and islet cells) was monitored during prospective follow-up. Stool and serum samples were collected for enterovirus detection by RT-PCR.
Administration of OPV increased enterovirus detected in stool samples from 11.3% to 38.9% (p < 0.001) during the first year of life. During the follow-up (median 11.0 years), at least one autoantibody was detected in 17.2% of children vaccinated with OPV and 19.1% with IPV (p = 0.723). At least two autoantibodies were observed in 3.1% and 6.8% of children, respectively (p = 0.384).
CONCLUSIONS/INTERPRETATION: Replication of attenuated poliovirus strains in gut mucosa is not associated with an increased risk of islet autoimmunity.
ClinicalTrials.gov : NCT02961595.
目的/假设：动物和人体研究表明，肠道病毒感染可能会调节胰岛自身免疫和 1 型糖尿病的风险。我们着手评估在遗传易感性儿童队列中，早期口服脊髓灰质炎活疫苗（OPV）的连续给药是否会影响胰岛自身免疫的启动。
OPV 被给予 64 名儿童，另有 251 名儿童接受了灭活脊髓灰质炎病毒疫苗（IPV）。在前瞻性随访期间，监测血清中与 1 型糖尿病相关的自身抗体（谷氨酸脱羧酶、胰岛瘤相关蛋白 2、胰岛素和胰岛细胞自身抗体）的出现。收集粪便和血清样本，通过 RT-PCR 检测肠道病毒。
OPV 的给药使粪便样本中检测到的肠道病毒从第一年的 11.3%增加到 38.9%（p<0.001）。在随访期间（中位数 11.0 年），OPV 接种组有 17.2%的儿童至少检测到一种自身抗体，IPV 接种组有 19.1%（p=0.723）。分别有 3.1%和 6.8%的儿童观察到至少两种自身抗体（p=0.384）。
结论/解释：肠道黏膜中减毒脊髓灰质炎病毒株的复制与胰岛自身免疫风险的增加无关。
ClinicalTrials.gov：NCT02961595。
