Compromised immune response in infants at risk for type 1 diabetes born by Caesarean Section

R. Puff, O. D'Orlando, A. K. Heninger, D. Kühn, S. Krause, C. Winkler, A. Beyerlein, E. Bonifacio, A. G. Ziegler

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Children born by Caesarean Section have a higher risk for type 1 diabetes. We aimed to investigate whether Caesarean Section leads to alterations of the immune response in children with familial risk for type 1 diabetes. We examined measures of innate and adaptive immune responses in 94 prospectively followed children, including 40 born by Caesarean Section. Proinflammatory serum cytokine concentrations were determined at age 6months. As a measure of vaccine response, IgG1, IgG2, and IgG4 tetanus antibody titers and CD4+ T cell proliferation against tetanus toxoid were quantified. Compared to infants born by vaginal delivery, infants born by Caesarean Section had lower concentrations of the cytokines IFN-γ (p=0.014) and IL-8 (p=0.005), and weaker CD4+ T cell responses to tetanus measured in the first (p=0.007) and second year (p=0.047) of life. Overall, our findings provide evidence that the mode of delivery influences the immune status and responsiveness during childhood.

Original languageEnglish
Pages (from-to)282-285
Number of pages4
JournalClinical Immunology
Issue number2
StatePublished - 1 Oct 2015
Externally publishedYes


  • Caesarean section
  • Cytokine
  • Immune responsiveness
  • Tetanus response
  • Type 1 diabetes


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