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PISA: Prenatal drivers of infant ISlet Autoimmunity

Type 1 diabetes mellitus (T1D) is an autoimmune disease affecting 1:500 children aged under 15 years in the UK. As childhood onset of T1D becomes more prevalent, there is an increasing need to understand how early life exposures could influence the development of the child and predispose to the development of autoimmunity.

Funded by The Leona M. and Harry B. Helmsley Charitable Trust, the PISA study will test the idea that different exposures in pregnancy may influence fetal development to increase the risk of childhood autoimmunity, in those infants already at higher risk. Infants born to mothers/fathers or first-degree relatives with T1D or born to mothers at risk of preterm birth have, in fact, a slightly higher risk of developing autoimmune diseases when young.

By assembling a diverse team of experts, our research focuses on several key objectives:

  1. Analysing existing data: we examine medical records of pregnant mothers whose children have been diagnosed with type 1 diabetes. This will help us identify patterns and potential links between maternal health during pregnancy and the development of the disease in their offspring.
  2. Creating a new cohort: we are recruiting women at a higher risk of preterm birth as well as mothers, fathers, or first-degree relatives with type 1 diabetes. We closely monitor these pregnancies, tracking instances of infections and other environmental factors until delivery.
  3. Studying neonatal immunity: our research focuses on understanding how the immune system develops in newborns. We investigate disruptions in immune development present at birth and explore the connections between neonatal immune function, the ongoing development of the immune system in the early years of life, and the subsequent emergence of Islet autoimmunity.
  4. Fetal pancreas assessment: to address our hypothesis, we will utilise fetal MRI measurements to observe the developing pancreas. By doing so, we aim to uncover potential links between fetal pancreatic development and the risk of developing type 1 diabetes.

By accomplishing these objectives, our research endeavours to shed light on the mechanisms behind the onset of Type 1 Diabetes in children. We aspire to enhance our ability to predict the emergence of this condition and gain valuable insights into potential preventive measures.

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Guy's and St Thomas' NHS Foundation Trust


The Leona M. and Harry B. Helmsley Charitable Trust