title: Compromised immune response in infants at risk for type 1 diabetes born by Caesarean Section.
abstract: Children born by Caesarean Section have a higher risk for type 1 diabetes. We aimed to investigate whether Caesarean Section leads to alterations of the immune response in children with familial risk for type 1 diabetes. We examined measures of innate and adaptive immune responses in 94 prospectively followed children, including 40 born by Caesarean Section. Proinflammatory serum cytokine concentrations were determined at age 6 months. As a measure of vaccine response, IgG1, IgG2, and IgG4 tetanus antibody titers and CD4(+) T cell proliferation against tetanus toxoid were quantified. Compared to infants born by vaginal delivery, infants born by Caesarean Section had lower concentrations of the cytokines IFN-ɣ (p=0.014) and IL-8 (p=0.005), and weaker CD4(+) T cell responses to tetanus measured in the first (p=0.007) and second year (p=0.047) of life. Overall, our findings provide evidence that the mode of delivery influences the immune status and responsiveness during childhood.
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Puff
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: O
authors.initials: O
authors.lastname: D'Orlando
authors.affiliation: DFG Research Center for Regenerative Therapies Dresden, Medical Faculty, Technische Universität Dresden, Fetscherstrasse 105, 01307 Dresden, Germany.
authors.forename: A-K
authors.initials: AK
authors.lastname: Heninger
authors.affiliation: DFG Research Center for Regenerative Therapies Dresden, Medical Faculty, Technische Universität Dresden, Fetscherstrasse 105, 01307 Dresden, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Kühn
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Krause
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany; Forschergruppe Diabetes e.V., Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Winkler
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Beyerlein
authors.affiliation: DFG Research Center for Regenerative Therapies Dresden, Medical Faculty, Technische Universität Dresden, Fetscherstrasse 105, 01307 Dresden, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Bonifacio
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany; Forschergruppe Diabetes e.V., Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany. Electronic address: anette-g.ziegler@helmholtz-muenchen.de.
authors.forename: A-G
authors.initials: AG
authors.lastname: Ziegler
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology*; D000907:Antibodies, Bacterial / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes; D016022:Case-Control Studies; D002585:Cesarean Section; D036861:Delivery, Obstetric; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000235:genetics / Q000276:immunology*; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G; D007223:Infant; D007371:Interferon-gamma / Q000276:immunology*; D016753:Interleukin-10 / Q000276:immunology; D018664:Interleukin-12 / Q000276:immunology; D053583:Interleukin-1beta / Q000276:immunology; D007376:Interleukin-2 / Q000276:immunology; D015850:Interleukin-6 / Q000276:immunology; D016209:Interleukin-8 / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D013744:Tetanus Toxin / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; C508606:CXCL8 protein, human; C508609:IL10 protein, human; C508585:IL1B protein, human; C508594:IL2 protein, human; C508600:IL6 protein, human; D007074:Immunoglobulin G; D053583:Interleukin-1beta; D007376:Interleukin-2; D015850:Interleukin-6; D016209:Interleukin-8; D013744:Tetanus Toxin; D013745:Tetanus Toxoid; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D018664:Interleukin-12; D007371:Interferon-gamma; D016178:Granulocyte-Macrophage Colony-Stimulating Factor
keywords: Caesarean Section; Cytokine; Immune responsiveness; Tetanus response; Type 1 diabetes