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Thinking outside the BOX

Project summary

Children of the Bart’s Oxford Study: insights into the changing dynamics of susceptibility to Type 1 diabetes

With support from Diabetes UK, Dr Kathleen Gillespie will extend the existing Bart’s–Oxford study, the world’s longest running family study of Type 1 diabetes. Her work will provide a unique resource of biological samples for the study of genetic risk factors, environmental influences and their impact on the immune system over time.

Background to research

The Bart’s–Oxford (or BOX) family study is the longest running family study of Type 1 diabetes anywhere in the world. It began in 1985 and tracks the health of over 3,900 families that include a child with Type 1 diabetes. The study has already been crucial in charting the rising occurrence of Type 1 diabetes in the UK and has helped to improve our understanding of the immune causes of Type 1 diabetes. This enables better prediction of who will get the condition so that they can receive the best possible care and be invited to join trials of new therapies. We know that the genes and markers connected to the immune attack that cause Type 1 diabetes are changing rapidly and are understood to be highly varied in different individuals. In future this could affect how people at risk of Type 1 are identified and recruited for clinical trials. It is vital that the BOX study continues to improve our understanding of these variations and changes.

Research aims

With support from Diabetes UK, Dr Kathleen Gillespie will extend the existing BOX study to provide a unique resource of biological samples for the study of genetic risk factors, environmental influences and their impact on the immune system over time. Her team will continue to recruit the families of children newly diagnosed with Type 1 diabetes, but will also extend recruitment among existing study participants to include the next generation of their family members. Using tried and tested methods, the researchers will examine blood samples from these individuals to look for important genes and risk markers. They will then work out how these have changed compared to those seen in the previous generation of each family. As events in early in life can be important for the development of Type 1 diabetes, the researchers will also focus on participants in the study who are pregnant, with the aim of following their health and the health of their children.

Potential benefit to people with diabetes

This research will extend the BOX study to include four generations of people with diabetes and their relatives. It will provide a unique resource of biological samples, so that researchers can study genetic risk factors, changing environmental influences and their impact on the immune system and the development of Type 1 diabetes over time in the same group of families. In particular, the study’s collection of DNA, blood and gut bacteria samples will help to reveal the dynamic effects of environment and genetics on babies, before birth and in early life. The understanding we will gain from this work will be vital for future efforts to prevent Type 1 diabetes.

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