A prospective role of coxsackie B and enterovirus infections in the pathogenesis of IDDM. Childhood Diabetes in Finland (DiMe) Study Group

University of Tampere Medical School, Finland.
Diabetes (Impact Factor: 8.1). 06/1995; 44(6):652-7. DOI: 10.2337/diabetes.44.6.652
Source: PubMed


Coxsackievirus B infections have been associated with clinical manifestation of insulin-dependent diabetes mellitus (IDDM) in several studies, but their initiating role in the slowly progressing beta-cell damage is not known. This is the first prospective study designed to assess the role of coxsackie B and other enterovirus infections in the induction and acceleration of this process. Three separate series were studied: 1) an intrauterine exposure series comprising 96 pregnant mothers whose children subsequently manifested IDDM and 96 control mothers whose children remained nondiabetic; 2) a cohort of 22 initially unaffected siblings of diabetic children who were followed until they developed clinical IDDM (mean observation time, 29 months) and 110 control siblings who remained nondiabetic; 3) a case-control series comprising 90 children with newly diagnosed IDDM and 90 control subjects. Enterovirus infections were identified on the basis of significant increases in serum IgG, IgM, or IgA class antibodies against a panel of enterovirus antigens (capture radioimmunoassay). Enterovirus antibodies were significantly elevated in pregnant mothers whose children subsequently manifested IDDM, particularly in cases in which IDDM appeared at a very young age, before the age of 3 years (P < 0.005). Serologically verified enterovirus infections were almost two times more frequent in siblings who developed clinical IDDM than in siblings who remained nondiabetic (mean, 1.0 vs. 0.6 infections/follow-up year; P < 0.001). This difference was seen both close to the diagnosis of IDDM and several years before diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

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    • "Coxsackie virus B (CVB) or LCMV does not cause diabetes RIP-IL6 mice Viral infections, especially with human enterovirus (HEV), have received much attention as potential environmental trigger of human T1D [4]. CVB has been shown to bear both enhancing and protective capacity in the NOD mouse model of T1D, depending on the context. "
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    • "These environmental risk factors may initiate autoimmunity or accelerate and precipitate an already ongoing beta cell destruction [91]. Potential risk factors, such as early foetal events [92], viral infections during pregnancy and postnatally [93] [94], and early exposure to cow's milk components and other nutritional factors [95] may initiate the autoimmune process. Since type 1 diabetes in childhood is associated with estimates of general wealth such as gross domestic product [96] it has been suggested that lifestyle habits related to wealth might be responsible for the changes in trend. "
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    • "Enterovirus infections have been shown to be a risk factor for several autoimmune diseases including insulin dependent diabetes mellitus (IDDM) (Dahlquist et al., 1995; Grist et al., 1978; Hiltunen et al., 1997; Hyoty et al., 1995). Multiple epidemiological studies in humans have established that children that manifest IDDM have had more exposures to enteroviruses than healthy subjects (Andreoletti et al., 1998; Clements et al., 1995; D'Alessio, 1992). "
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