Live attenuated enterovirus vaccine (OPV) is not associated with islet autoimmunity in children with genetic susceptibility to type 1 diabetes: prospective cohort study

Diabetologia. 2018 Jan;61(1):203-209. doi: 10.1007/s00125-017-4410-4. Epub 2017 Sep 2.

Abstract

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.

Methods: 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.

Results: 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.

Trial registration: ClinicalTrials.gov : NCT02961595.

Keywords: Autoantibody; Enterovirus; Inactivated polio vaccine; Oral polio vaccine; Type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral / immunology
  • Autoantibodies / immunology
  • Autoimmunity / genetics
  • Autoimmunity / physiology
  • Diabetes Mellitus, Type 1 / genetics*
  • Diabetes Mellitus, Type 1 / prevention & control
  • Diabetes Mellitus, Type 1 / virology*
  • Enterovirus / genetics*
  • Genetic Predisposition to Disease / genetics*
  • Humans
  • Poliovirus Vaccine, Oral / therapeutic use
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • Antibodies, Viral
  • Autoantibodies
  • Poliovirus Vaccine, Oral

Associated data

  • ClinicalTrials.gov/NCT02961595