About the PAGE-study
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With the combined effort of experts from different fields in Norway and abroad, we believe these studies can provide a novel insight that may lead to preventive measures against type 1 diabetes and coeliac disease in the future.
Genes (HLA-DQ2 and -DQ8) strongly predispose for both diabetes and coeliac disease. Consumption of wheat products is necessary for the expression of coeliac disease but most of the susceptible children do not develop the disease. Increasing incidence over the past decades suggests involvement of non-genetic factors not yet identified.
Nutritional and infectious factors are suspected and the early onset and other lines of evidence suggest that in utero and early postnatal exposure is important. Such exposures are difficult to study in retrospective studies.
By following over 100,000 pregnancies in the MoBa study, we can identify children who later develop type 1 diabetes and coeliac disease via linkage to national registries in sufficient numbers to perform prospective studies. When the study begins in late 2013, approximately 250 children in MoBa will have developed type 1 diabetes and nearly 500 will have developed coeliac disease.
Stored blood samples from the mother during pregnancy and from the umbilical cord will be tested for selected markers of perinatal environment to investigate whether these can predict future development of coeliac disease and type 1 diabetes, together with genetic factors.
Vitamin D metabolites, cytokines and other biomarkers in cord blood will be investigated as potential predictors of future disease in the children. Furthermore, we will investigate the association between quantity of maternal cells in the foetal circulation ("maternal microchimerism") and type 1 diabetes or coeliac disease in children. Small but variable quantities of maternal cells may potentially mediate in utero effects.
With the combined effort of experts from different fields in Norway and abroad, we believe these studies can provide a novel insight that may lead to preventive measures against type 1 diabetes and coeliac disease in the future.
