الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 91 |  |  |
| | | from | 91 | | |
Abstract
T1DM is an autoimmune disease characterized by insufficient insulin production as a result of T-cell-mediated destruction of insulin-secreting pancreatic beta cells. It is the result of a complex interaction between different degrees of genetic susceptibility and environmental factors. T1DM is associated with a significant burden, mostly related to the development of vascular complications.
The gastrointestinal tract harbors a complex and dynamic population of microorganisms, the gut microbiota, which exert a marked influence on the host homeostasis and metabolic diseases. Recent evidence shows that altered gut bacterial composition (dysbiosis) is highly associated with the pathogenesis of insulin dysfunction and T1DM and, thus, targeting gut microbiota may serve as a therapeutic potential for T1DM patients. Microbiota assortment could represent the boundary between environmental and genetic risk factors that convey in T1DM.
This study was designed to identify differences (and/or similarities) in the gut enterotypes of Egyptian patients with T1DM and controls, in an attempt to identify the enterotypes that are likely related to T1DM. In addition, to identify and quantitate some intestinal bacteria as Bacteroidetes, Prevotella, Rumnicocci, Lactobacilli, Lactobacillus johnsonii, Lactobacillus reuteri and Veillonella that were previously hypothesized to be associated with T1DM.
Fourty T1DM patients, who presented to the Diabetology clinic of Alexandria main university hospital, were enrolled in the present study. Twenty age and sex matched controls group were also included.
Stool samples were collected from patients and controls. Quantitative real time PCR using SYBR green was performed for the identification and quantitation of the selected bacteria. The results of gut microbiota composition were analyzed and interpreted for those 40 cases only in comparison to 20 healthy individuals of the control group in order to study the effect of environmental components on the gut microbiota composition.
Enterotype 1 was the most prevalent enterotype found in both study groups. enterotype 1 was detected in 30 (75%) T1DM patients and 13 (65%) individuals in control group. On the other hand, enterotype 2 was detected in 10 (25%) T1DM patients versus 7 (35%) individuals of the control group. No statistical significance was found between the two groups as regard enterotype 1 and enterotype 2. Enterotype 3 was not detected in both cases and controls group.
The relationship between enterotypes of T1DM patients and different variables including ; age, gender, BMI, smoking, duration of the disease, HbA1c and FBS was studied showing that there was statistically significant difference between different enterotypes with BMI, which was significantly higher in Enterotype 2 than Enterotype 1 and HbA1c which was significantly higher in Enterotype 2 than Enterotype1.
By quantification of the selected bacteria, T1DM patients showed significantly higher bacteroides (5.82E-01) and Lactobacillus johnsonii (5.11E-03) but Veillonella (2.26E-03) was significantly higher in control group.