Abstract

Type 1 diabetes (T1D), an autoimmune disease, breaks out in some of the children who has genetic susceptibility to T1D. Besides genetic susceptibility some environmental factor(s) are required to trigger the disease. The incidence of T1D in Finland is highest in the world, so we must seek an environmental factor, that is typical for Finland and can declare many aspects of T1D epidemiology and biology. In the literature most popular trigger has been enterovirus infections. It is difficult however to find why enteroviruses would be in this role in Finland in contrary to neighbouring countries e.g. Sweden.Colloidal amorphous silica (ASi) is typical for Finnish environment in consequency of the geohistory of Finland, great part of Finland is an ancient lake and sea bottom. ASi concentrations in natural waters are high in April–June and in November, only traces can be found in the rest of months. Pure colloidal ASi is not a strong trigger for T1D, but ASi particle which has surface adsorbed tetrahedrally coordinated zinc (ASiZn) is probably the trigger which has kept it’s secret up to date. Zn functions as address label which conducts the ASiZn particle to the beta cell, whose content of zinc is highest in the body. ASi particle adheres to membrane proteins distorting their tertiary structure revealing new epitopes. If the fetus has not met these epitopes at proper time during intrauterine development, the consequence is that the negative selection of lymphocytes in the thymus and bone marrow and fetal liver is not perfect. When a child later in postnatal life becomes predisposed to ASiZn particles the immune system reacts to these as to nonself proteins. As a consequence the insulin producing beta cells are destroyed.Many observations from diabetes research support the hypothesis, some to mentioned. 1. Three common autoantigens (ZnT8, ICA512/IA-2, GAD65) are membrane proteins whose function zinc regulates. 2. Geographical variation in Finland is convergent with surface water manganese concentrations. Manganese is the principal Zn scavenger and high manganese in water reduces ASiZn particle formation and the incidence of T1D. 3. The incidence of T1D depends of drinking water pH. The highest incidence can be found within water pH 6.2–6.9. Zn coordination changes from octahedral (unphysiologic) to tetrahedral (physiologic) at pH 6.56. In the text are presented five more supporting observations e.g. the similarity between the soils in Sardinia and Finland in respect to ASi.

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