Autoimmune comorbidity in type 1 diabetes and its association with metabolic control and mortality risk in young people: a population-based study.

AIMS/HYPOTHESIS: This register-based study aimed to describe autoimmune comorbidity in children and young adults from type 1 diabetes onset, and to investigate whether such comorbidity was associated with a difference in HbA1c or mortality risk compared with children/young adults with type 1 diabetes without autoimmune comorbidity. METHODS: A total of 15,188 individuals from the Swedish National Diabetes Register, registered with type 1 diabetes before 18 years of age between 2000 and 2019, were included. Five randomly selected control individuals from the Swedish population (Statistics Sweden) were matched to each individual with type 1 diabetes (n=74,210 [346 individuals with type 1 diabetes were not found in the Statistics Sweden register at the date of type 1 diabetes diagnosis, so could not be matched to control individuals]). The National Patient Register was used to attain ICD-10 codes on autoimmune diseases and the Cause of Death Register was used to identify deceased individuals. RESULTS: In the total type 1 diabetes cohort, mean±SD age at onset of type 1 diabetes was 9.5±4.4 years and mean disease duration at end of follow-up was 8.8±5.7 years. Of the individuals with type 1 diabetes, 19.2% were diagnosed with at least one autoimmune disease vs 4.0% of the control group. The HRs for comorbidities within 19 years from onset of type 1 diabetes were 11.6 (95% CI 10.6, 12.6) for coeliac disease, 10.6 (95% CI 9.6, 11.8) for thyroid disease, 1.3 (95% CI 1.1, 1.6) for psoriasis, 4.1 (95% CI 3.2, 5.3) for vitiligo, 1.7 (95% CI 1.4, 2.2) for rheumatic joint disease, 1.0 (95% CI 0.8, 1.3) for inflammatory bowel disease, 1.0 (95% CI 0.7, 1.2) for systemic connective tissue disorder, 1.4 (95% CI 1.1, 1.9) for uveitis, 18.3 (95% CI 8.4, 40.0) for Addison's disease, 1.8 (95% CI 0.9, 3.6) for multiple sclerosis, 3.7 (95% CI 1.6, 8.7) for inflammatory liver disease and 19.6 (95% CI 4.2, 92.3) for atrophic gastritis. Autoimmune disease in addition to type 1 diabetes had no statistically significant effect on HbA1c or mortality risk. CONCLUSIONS/INTERPRETATION: To our knowledge, this is the first comprehensive study where young individuals with type 1 diabetes were followed regarding development of a wide spectrum of autoimmune diseases, from onset of type 1 diabetes. In this nationwide and population-based study, there was already a high prevalence of autoimmune diseases in childhood, especially coeliac and thyroid disease. The presence of autoimmune comorbidity did not have a statistically significant effect on metabolic control or mortality risk.

Improving membrane activity of oligonucleotides by cetylpyridinium chloride: an electrochemical study.

The interaction of phospholipid membranes and oligonucleotides complexed with a positively charged surfactant is reported. Phospholipid membranes were assembled at the interface between an immobilized organic phase and an aqueous phase using the Langmuir-Blodgett (L-B) technique. The interaction and adsorption of the naked oligonucleotides and oligonucleotides complexed with cetylpyridinium chloride (CP) was studied electrochemically using cyclic voltammetry (CV) and ac-voltammetry. Interfacial capacitance, obtained indirectly from ac-voltammetry as a function of interfacial potential, was fitted to the theory based on the solution of the Poisson-Boltzmann equation. It was shown that both types of naked oligonucleotides (phosphoromonothioates and phosphodiesters) adsorb on the lipid monolayers poorly. The introduction of CP to the system increases the adsorption efficiency significantly. However, one phosphoromonothioate appeared to form a compact globule with CP instead of adsorbing to the lipid membrane. These results demonstrate that electrochemical methods are a powerful tool for probing the behavior of drugs in the vicinity of model cell membranes.

Effect of gramicidin on phospholipid-modified monolayers and on ion transfer at a liquid-liquid interface.

The interaction of hybrid lipid/gramicidin A (gA) monolayers with dextran sulfate (DS) and the effect of this interaction on ion transfer at a liquid-liquid interface is reported. The interfacial and physicochemical properties are studied with Langmuir-Blodgett (LB) and electrochemical techniques. The results obtained from compression isotherms demonstrate that the interactions between the different species in the hybrid monolayer vary according to the chemical nature of the lipid (hydrocarbon region and charge of the head group). Interfacial capacitance measured with AC voltammetry indicates that the DS chains form a rather flat and compact layer when adsorbed to either zwitterionic or negatively charged phospholipid monolayers, and that calcium, even at low concentrations, interacts with the monolayers. These results are successfully described by a model based on the solution of the Poisson-Boltzmann equation in the interfacial region. Ion transfer and interactions with the lipid/gA/DS-modified monolayers were also studied with electrochemical techniques. Admittance data show that although the studied ions are not using gA channels for the transfer through the lipid membranes, the incorporation of gA in the lipid domain and the adsorption of DS at the interface have a significant effect on ion transfer across the monolayers. This effect can be explained as a consequence of the modified surface charge and of the compactness of the lipid domain due to its interaction with gA and to calcium and DS adsorption at the interface. The ion-transfer rate, therefore, depends on the composition of the monolayer and the chemical nature of the ion.

Channel flow configuration for studying the kinetics of surfactant-polyelectrolyte binding.

A novel channel flow configuration was developed and utilized for studying the poly(styrenesulfonate)-cetylpyridinium ion interaction kinetics. The surfactant solution was continuously injected into a flow of polyelectrolyte solution, and the extent of the association reaction was probed at an ion-selective detector electrode. The system was modeled within an analytical approximation, which was tested by a finite-element simulation of the full convective mass transport problem including the homogeneous complexation reaction. The results show that association kinetics can be resolved and that the initial steps of the reaction are not influenced by intermolecular interactions between the bound surfactants. The presented methodology is general, and further development should enable the study of complex cooperative kinetics of surfactant-polyelectrolyte systems.