Role of enteroviruses in the pathogenesis of type 1 diabetes

Excerpt

The pathogenesis of type 1 diabetes is widely believed to involve T cell-mediated autoimmune processes directed against the insulin-producing beta cells in the pancreas. Growing evidence suggests that environmental factors, including toxins, food antigens and, particularly, viral infections are involved in the induction of type 1 diabetes. Viruses such as enteroviruses, rubella virus, mumps virus, rotavirus, parvovirus and cytomegalovirus have been investigated in experimental and clinical studies aimed at defining their roles in the pathogenesis of type 1 diabetes. Most efforts in recent years have focused on enteroviruses, the most common cause of viral infection in humans, infecting an estimated billion people annually worldwide [1]. Enteroviruses exhibit islet cell tropism, as demonstrated by the detection of viral RNA by in situ hybridisation and the identification of viral proteins by immunohistochemical staining of post-mortem pancreatic specimens from type 1 diabetogenic patients [2, 3]. Furthermore, an infectious coxsackievirus B4 was isolated from the islets of a type 1 diabetic patient [2], and a strain of echovirus 3 was isolated from an individual concurrently with appearance of islet cell and IA-2 autoantibodies [4]. …