Trigger 5: A vaccine? Flashcards
genetic susceptibility to the disease is mainly regulated by
genes in the HLA (MHC complex) locus
New findings haves suggested that
enterovirus’ play an important role in the aetiology of T1DM
if a vaccine could target specific virus’ that cause T1D
then incidence may decrease
why cant we use an existing vaccine
- may not have enough capsid protein
- could trigger autoimmunity
- specific serotypes
- no one has developed a vaccine which recognises serotypes of enterovirus which affect the pancreas
what could be targeted by viral vaccine
capsid or RNA- a targeted protein component
targeted vaccination
could vaccinate those at highest genetic risk e.g. HLA mutations
role of media in communicating science to the public- negative
o May lead to scaremongering
o May lead to patients demanding vaccines
- Stereotyping
- Increase in diabetes misrepresentation in the media e.g. people may think T1D is infectious
role of media in communicating science to the public- positive
- could increase support for funding by the government
- If screening strategies are adopted, the media could help with advertisement and uptake
what trial would have to be carried out to show that a vaccine prevents type 1 dibetes
prospective cohort - in animal model and then humans
sample size of study
would have to be large
nature of sample size
have to be vaccinated when babies (representative of UK population)
challenge of this type of study
- have to be long (people can get T1D in 50s)
- dropout
- have to be highly powered- expensive
does the scale of the problem warrant such a study
potentially not- could think about screening for babies with T1D specific mutations e.g. HLA
safety considerations of trial
Would have make sure the vaccine was tested in animals models and then a group of healthy adults, to ensure that the vaccine didn’t cause any adverse reactions
practical considerations of trial
- Will be hard to convince potentially hundreds of thousands of parents to give permission to vaccinate their children
- Parents are already untrusting of vaccines
o For vaccinations to be effective 95% of population need to have it - Practicality of following participants up for such a long period of time- withdrawals (due to onset taking place between the ages of 0 to +50).
is it possible that some virus’ could protect against type 1 diabetes
The hygiene hypothesis suggests that exposure to microbial agents may be beneficial for the development of a balanced immune system and its ability to maintain self-tolerance.
infection by which pathogens have been showed to reduce incident elf T1D
by LCMV, enteroviruses, helminths, salmonella have been showed to significantly reduce T1D incidence.
heritability of T1D
Although some genetic predisposition is associated with T1D, this association is regarded as weak
in monozygotic twins the concordance rate is
well below 50%
the disease also occurs in individuals who
carry protective genetic variations
those genetically predisposed to mount a large response to virus
are more at risk of amounting an autoimmune response which trigger T1D
why is T1D not an infectious disease
it is the human response to an enterovirus which can trigger T1D via autoimmune response
possible side effects of vaccine
- Vaccination could make someone more sensitive to virus
- Adverse reaction
in T1D we are talking about
polymorphism and not mutation
