More than 400,000 people in the UK—including 30,000 children—live with type 1 diabetes, a condition requiring lifelong daily insulin injections. The disease arises when the immune system destroys insulin-producing pancreatic cells, driven by a mix of genetic and environmental factors. Since the 1950s, type 1 diabetes incidence has risen in step with increased antibiotic use in childhood. This project tests a specific theory: that antibiotics disrupt the gut microbiome—the community of microorganisms that helps train the immune system—and that a disrupted microbiome raises diabetes risk. A gene called DEXI may link microbiome health to immune function. The researchers will use three approaches. In a mouse model of type 1 diabetes, they will track how the microbiome changes over life and whether a functional DEXI gene alters that relationship. They will also analyse a large veterinary database to see whether antibiotic use predicts diabetes in pet dogs, which share human environments and develop spontaneous insulin-dependent diabetes. Finally, they will develop new methods to detect the DEXI protein in human blood, enabling future studies of its role in immune development. This is fundamental science. If it confirms that microbiome disruption drives diabetes risk, it could open the door to preventive strategies—such as reducing unnecessary antibiotic prescriptions or developing microbiome-supporting therapies—that might slow the disease’s rising incidence.
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Type 1 diabetes (T1D) affects more than 400,000 people in the UK including up to 30,000 children. Treatment involves lifelong daily insulin injections and the disease arises as the result of genetic and environmental factors, which cause the immune system to destroy the cells in the pancreas which normally produce insulin. This project is aimed at understanding more about the risk factors involved in type 1 diabetes (T1D) and in particular whether it might be possible to reduce the risk of T1D by making environmental changes. The incidence of T1D has been rising year on year since the 1950s, coinciding with more frequent use of antibiotics for childhood infections. One theory is that antibiotics disrupt the balance of micro-organism in the gut (known as the microbiome). The microbiome is known to be involved in the development of the immune system and a healthy microbiome is thought to be involved in protecting against the development of T1D. Studies of the microbiome in children affected with T1D demonstrate many differences in the type, frequency and diversity of micro-organisms compared to the microbiome of children without T1D. Mouse models of T1D such as the NOD (non-obese diabetic) mouse have also demonstrated a relationship between antibiotic use and T1D risk. In addition, recent evidence has suggested that a gene called DEXI may be involved in microbiome development, as well as T1D risk. This proposal will examine the relationship between the microbiome, the DEXI gene and T1D risk. In the NOD model, the microbiome will be examine by looking at the genetic material from micro-organisms in the faeces, throughout the life course. The effect on the microbiome of of having an functional or non-functional Dexi gene will also be explored. In addition, the impact of measures to improve microbiome health on the development of T1D on this model will also be explored. In addition, a new model for studying the microbiome and diabetes development will be explored. Pet dogs can develop spontaneous insulin-dependent diabetes mellitus just like young humans and importantly they have the advantage over the NOD model that they share our environment. This study will also use a large veterinary database to assess the impact of antibiotic use on the risk of diabetes development in pet dogs. In addition, samples of faeces will be collected from pet dogs undergoing treatment for newly diagnosed diabetes in a veterinary hospital, as well as non-diabetic dogs to determine if the same relationship between microbiome and diabetes exists in dogs as in children. Finally, the role of DEXI in the human immune system will be explored. New methods of detection of the DEXI protein in blood samples and the immune system will be developed, to allow the relationship between DEXI, the microbiome and the development of the human immune system to be explored in future.
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