Diet, cow's milk protein antibodies and the risk of IDDM in Finnish children

Abstract

Summary Associations of infant feeding patterns and milk consumption with cow's milk protein antibody titres were studied in 697 newly-diagnosed diabetic children, 415 sibling-control children and 86 birth-dateand sex-matched population-based control children in the nationwide "Childhood Diabetes in Finland" study. IgA and IgG antibody titres to the proteins of cow's milk formula, BLG and BSA, and IgM antibody titres to cow's milk formula proteins were measured by ELISA. Several inverse correlations were observed between the duration of breast-feeding or age at introduction of dairy products and antibody titres, and positive correlations were observed between milk consumption and antibody titres in all three populations studied. Multivariate analyses which included the infant feeding variables, milk consumption and current age simultaneously showed that the earlier the introduction of dairy products and the greater the consumption of milk was, the higher several antibody titres were. High IgA antibody titres to cow's milk formula were associated with a greater risk of IDDM both among diabeticpopulation-control and diabetic-sibling-control pairs when adjusted for other cow's milk antibody titres, dietary variables and in diabetic-sibling-control pairs also for ICA. The results suggest that young age at introduction of dairy products and high milk consumption during childhood increase the levels of cow's milk antibodies and that high IgA antibodies to cow's milk formula are independently associated with increased risk of IDDM. [Diabetologia (1994) 37: 381-387]

Cellular and Humoral Immunity against Cow's Milk Proteins in Type 1 Diabetes

“…Similarly, the decline of these immune responses with age is faster for IgG, which start to diminish during the first year of life, than for IgA, which sometimes persist during childhood [39,42,43]. These transient immune responses probably have a protective anti-inflammatory role and usually cause no pathologic consequences, whereas more pronounced and persistent immune responses are found in milk allergy [37,46] and in milder form have also been associated with type 1 diabetes [13][14][15][16][17][18][19][20][21][22]. The association of humoral responses to cow's milk proteins with type 1 diabetes has been conflicting.…”

“…Nine (39%) patients and four (18%) control subjects had SI >3 against -casein (P=0. 19), all but one of these also having elevated responses to -casein. Three patients (age 11, 27 and 31 years) and one control subject (age 37 years) had relatively strong responses (SI >9) against both -and -casein, and one control subject (age 40 years) against -casein only.…”

“…Much attention has been given to early infant diet [5,6], and in particular to a possible role of cow's milk [7], on the basis of studies performed in animal models that show modification of diet may influence diabetes onset [8][9][10], and of reports of increased risk of diabetes associated with reduced breast feeding time [11,12]. Moreover, the finding of specific milk proteins as targets of humoral and cell-mediated immunity to cow's milk in patients with type 1 diabetes [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] has elaborated several theories of autoimmunity induced through molecular mimicry. Although reports in favour of this hypothesis are numerous, other studies have failed to confirm the original findings [15,25,26,[28][29][30][31][32] and it still remains controversial as to whether cow's milk is involved in the autoimmunity leading to diabetes.…”

“…Antibody and T cell responses to the cow's milk proteins bovine serum albumin (BSA) [14,15,[18][19][20][21][22][23][24] and -lactoglobulin [13,16,17,19,22,25] have been reported in patients with type 1 diabetes. However, these reports are inconsistent [15,25,26,28,29].…”

Molecular mimicry in autoimmune disease

“…There is epidemiological evidence that a short breast feeding time and early ingestion of cows’ milk is a risk factor for diabetes 17. In cows’ milk, the proportion of protein as casein is higher (85%) than in human milk (25%); a large proportion of this is β casein.…”