Pediatric Autoimmunity

Dept of Clinical Sciences Malmö

PI: Annelie Carlsson

Group members

Annelie Carlsson, Docent, MD, PI
Maria Elfving, PhD
Charlotte Nilsson, Post Doc
Qefsere Brahimi, BMA
Charlotta Webb, PhD
Lisa Engleson, PhD student
Maria van der Pals, PhD student
Kristel Björkman, Research Nurse

Autoimmune disorders are the most common chronic diseases in the childhood population, whereas Type 1 diabetes, Celiac Disease and Thyroid disease are the most frequent.

The incidence of Type 1 diabetes (T1D) in Sweden is highest in the world, next to Finland, and has more than doubled the last 30 years. T1D is by far the most common chronic and serious disease in our childhood population and tends to become an extremely serious global problem. More than 800 children below the age of 18 develop diabetes yearly in Sweden and 8000 children with diabetes are currently being treated at the paediatric clinics. The ethiology of T1D is so far open.

T1D is perceived as a chronic immune-mediated disease with a subclinical prodromal period characterized by selective loss of insulin-producing β cells in the pancreatic islets of genetically susceptible subjects. Genetic factors have been estimated to contributing to disease susceptibility are located in the HLA region and the highest risk is associated with the HLA DQA1*05-DQB1*0302. Both genes are the same HLA-aoleles which also confer risk for Celiac Disease. Swedish children with T1D have since 2005 been carefully studied by us within the nation BDD study (Better Diabetes Diagnostic) with respect to HLA and autoantibodies.

New environmental changes are proposed to influence the development of T1D and more children with before less genetic risk develop today the disease. The childhood populations seems also to be more heterogeneous today. Some patients are hard to classify whether they have T1D, Type 2 diabetes or something in between, or have MODY (maturity onset diabetes in the young).

Our focus is to use data from the BDD-study together with clinical data from our nation childhood registry to get a better diabetes classification for every child with the intention that each child will receive an individualized  treatment.

We study the gene environment interaction behind the increased incidence of T1D, where we test the hypothesis that Type 1 and Type 2 diabetes to some extend share the same environmental triggers. We are also interested to investigate if different set of genes related to Type 2 diabetes are also related to T1D. We want to examine if there are differences in risk of developing late complications between the children with different set of genes.

Celiac Disease (CD) is the most common autoimmune disease in the Swedish childhood population and affect about 1%-3% of the Swedish children. Currently, the only effective treatment is a strict gluten-free diet. CD is a well-known comorbidity to T1D. It is individuals with similar geentic predisposition. Between 5,5-10,4% of children with diabetes are diagnosed with CD.

Sweden, exclusively, experienced an "epidemic" in children younger than 2 years of age during 1986-1996. This has been related to the change in gluten introduction in infancy 1986. Our group has shown that children born during different national regimen of gluten introduction in infancy had different risk to develop CD at 12-years of age.  We are now studying if thee are any changes in Celiac Diseases´related comorbidities between these birth cohorts with differences in gluten introduction in infancy.
We are investigating if the gluten introduction influenced other autoimmune diseases in these different birth cohorts, such as thyroid disease and diabetes, in the childhood population. We are also interested in studying if gluten as such, influences the remission period in children with diabetes and the risk to develop CD.

Related studies and other related information

Last updated: June 5, 2014
Website contact: LUDC webteam

LUDC, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00