Elevated Markers of Intestinal Barrier Dysfunction and TLR2 Ligands in Individuals with Type 1 Diabetes

Studies suggest that alterations of intestinal barrier function and a subsequent increased translocation of bacterial endotoxins may be critical in type 1 diabetes mellitus (T1DM) and may contribute to the proinflammatory state of patients. If Gram-positive derived bacterial toxins are also altered in the setting of T1DM is not yet clarified. In the present study, using a SEAP reporter assay and ELISA, markers of intestinal permeability, concentration of Toll like receptor (TLR) 2 ligands and soluble CD14 (sCD14) were assessed in serum of individuals with T1DM (n=19, m: 10/ f: 9) and age-matched healthy controls (n=18, m: 3/ f: 15) from the LatDiane study. BMI and HbA1c were significantly higher in individuals with T1DM. Serum concentrations of intestinal fatty acid binding protein (I-FABP) were significantly higher in individuals with T1DM than in controls as were concentrations of TLR2 ligands and sCD14 protein. A multivariable linear regression analysis revealed an independent association of T1DM with higher TLR2 ligand levels. Our findings indicate that not only bacterial endotoxin but also TLR2 ligands are elevated in patients with T1DM.