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The effect of gluten-free diet on β-cell residual capacity, immune function and gut microbiome in children with newly diagnosed type 1. diabetes
Neuman, Vít ; Šumník, Zdeněk (advisor) ; Pelikánová, Terezie (referee) ; Škvor, Jaroslav (referee)
The effect of gluten-free diet on β-cell residual capacity, immune function and gut microbiome in children with newly diagnosed type 1. diabetes Abstract The pathophysiology of the onset and progression of type 1 diabetes (T1D) is not fully understood. Gluten has a proinflammatory effect on the immune system and is therefore considered as one of the factors affecting the onset and progression of T1D. The aim of the thesis is to allow a complex insight into the role of the GFD on the residual β-cell capacity, T1D control, gut microbiome, gut permeability, subtypes of immune cells and the effect of gut microbiome transfer into germ-free non-obese diabetic (NOD) mice on the incidence of diabetes. On the group of 45 children with T1D (26 intervention group, 19 control group) we proved the association of the GFD with slower decrease of β-cell residual capacity (the difference in the trend of C-peptide decrease 409 pmol/l/year; p = 0,04) and lower HbA1c (by 7,8 mmol/mol; p=0,02). We also described the changes in the gut bacteria that were differentially abundant after the administration of the GFD and the changes in abundance of the regulatory and effector immune cells. We showed there was no change in the gut permeability with respect to the study group. We also proved that the transfer of human gut microbiota...
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Evaluation of neonatal laboratory screening efficacy in the Czech Republic and its improvements
David, Jan ; Votava, Felix (advisor) ; Černá, Marie (referee) ; Škvor, Jaroslav (referee)
INTRODUCTION: Newborn laboratory screening is a process used for early detection and treatment of selected rare diseases which leads to improvement in patient quality of life. All diseases included in newborn laboratory screening are classified as rare diseases, defined by a population frequency less than 1:2 000. The evaluation of newborn laboratory screening is an important tool for its improvements. The main aim of this doctoral thesis was to evaluate clinical and population-wide efficacy and balance detection rate and impact on healthy part of population. METHODS: The doctoral thesis was based on results from screening laboratories in period 2002-2017 in the Czech Republic. Dried blood spots from newborns were analyzed using fluorescence immuno-assay, tandem mass spectrometry and fluorimetry. RESULTS: The outcomes of this doctoral thesis led (1) to objectify prevalence of rare diseases in the Czech Republic, (2) to objectify association between prevalence of screened diseases and newborn birthweight, (3) to propose the change of decision limits of screening of 21-hydroxylase deficiency with aim to decrease high false positivity and negative impact on health part of population, (4) to define recommendations for managing of patients screened as positive in the 21-hydroxylase deficiency newborn...
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