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Innate immune activity is detected prior to seroconversion in children
with HLA-conferred type 1 diabetes susceptibility
Henna Kallionpää,1,2,19,* Laura L. Elo,1,3,* Essi Laajala,1,4,5,19,*, Juha Mykkänen,1,6,18,19 Isis Ricaño
Ponce,7 Matti Vaarma,8 Teemu D. Laajala,1 Heikki Hyöty,9,10 Jorma Ilonen,11,12 Riitta Veijola,13
Tuula Simell,6,19 Cisca Wijmenga,7 Mikael Knip,14−16,19 Harri Lähdesmäki,1,4,19 Olli Simell,6,18,19
and Riitta Lahesmaa1,19
1Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, FI 20521 Turku, Finland. 2Turku Doctoral Programme of Biomedical Sciences, FI 20520 Turku, Finland. 3Biomathematics Research Group, Department of Mathematics, University of Turku, FI 20014 Turku, Finland. 4Department of Information and Computer Science, Aalto University School of Science, FI 00076 Aalto, Finland. 5The National Graduate School in Informational and Structural Biology, FI 20520 Turku, Finland 6Department of Pediatrics, University of Turku, FI 20014 Turku, Finland. 7University of Groningen, University Medical Centre, Department of Genetics, Groningen 9700 RB, The Netherlands 8Deparment of Signal Processing, Tampere University of Technology, FI 33101 Tampere, Finland. 9Department of Virology, University of Tampere, FI 33014 Tampere, Finland. 10Fimlab Laboratories, Pirkanmaa Hospital District, FI 33520 Tampere, Finland. 11Immunogenetics Laboratory, University of Turku, FI 20014 Turku, Finland. 12Department of Clinical Microbiology, University of Eastern Finland, FI 70211 Kuopio, Finland. 13Department of Pediatrics, University of Oulu and Oulu University Hospital, FI 90014 Oulu, Finland. 14Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, FI 00014 Helsinki, Finland. 15Folkhälsan Research Center, FI 00290 Helsinki, Finland. 16Department of Pediatrics, Tampere University Hospital, FI 33521 Tampere, Finland. 17Department of Information and Computer Science, Aalto University School of Science, FI 00076 Aalto, Finland. 18Department of Pediatrics, Turku University Hospital, FI 20520 Turku, Finland. 19The Finnish Centre of Excellence in Molecular Systems Immunology and Physiology Research. *H.K., L.L.E., and E.L. contributed equally to this study.
CORRESPONDING AUTHOR: Riitta Lahesmaa, M.D., Ph.D., Professor Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, P.O. Box 123, FI 20521 Turku, Finland. Tel. +358 2 333 8601 Fax +358 2 215 8808 E mail: [email protected]
Short running title: Innate immune activity detected in prediabetes
Word count: 4134 Number of tables and figures: 7
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Diabetes Publish Ahead of Print, published online February 18, 2014 Page 3 of 111 Diabetes
ABSTRACT
The insult leading to autoantibody development in children who will progress to develop type 1
diabetes has remained elusive. To investigate the genes and molecular pathways in the pathogenesis
of this disease, we performed genome wide transcriptomics analysis on a unique series of
prospective whole blood RNA samples from at risk children collected in the Finnish Type 1
Diabetes Prediction and Prevention (DIPP) study. We studied 28 autoantibody positive children,
out of which 22 progressed to clinical disease. Collectively the samples covered the time span from
before the development of autoantibodies (seroconversion) through the diagnosis of diabetes.
Healthy controls matched for date and place of birth, gender and HLA-DQB1 susceptibility were
selected for each case. Additionally, we genotyped the study subjects with Immunochip to identify
potential genetic variants associated with the observed transcriptional signatures. Genes and
pathways related to innate immunity functions, such as the type 1 interferon response, were active
and interferon response factors (IRFs) were identified as central mediators of the interferon related
transcriptional changes. Importantly, this signature was detected already before the type 1 diabetes
associated autoantibodies were detected. Together, the data provide a unique resource for new
hypotheses explaining type 1 diabetes biology.
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By the time of clinical diagnosis of type 1 diabetes, an estimated 80 90% of the insulin producing pancreatic beta cells have been destroyed by autoimmune mechanisms with immune cells infiltrating the islets. Autoantibodies against beta cell