Immunology in the clinic review series: focus on type 1 diabetes and viruses: the role of viruses in type 1 diabetes: a difficult dilemma

• Published in: Clinical and experimental immunology 2012-04, Vol.168 (1), p.5-11
• Main Authors: Coppieters, K. T., Wiberg, A., Tracy, S. M., von Herrath, M. G.
• Format: Article
• Language: English
• Subjects: Analytical, structural and metabolic biochemistry; Animals; Autoimmunity; beta cells; Biological and medical sciences; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - etiology; Diabetes Mellitus, Type 1 - immunology; Diabetes Mellitus, Type 1 - virology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Enterovirus - immunology; Enterovirus - pathogenicity; Enterovirus Infections - complications; Enterovirus Infections - immunology; Enterovirus Infections - virology; Epidemiology. Vaccinations; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fundamental and applied biological sciences. Psychology; General aspects; Hepatitis E virus; Host-Pathogen Interactions; Humans; Hygiene; Hyperglycemia - immunology; Immune system; Immunomodulation; Infection; Infectious diseases; Insulin-Secreting Cells - immunology; Insulin-Secreting Cells - virology; Insulitis; Islets of Langerhans; Medical sciences; Metabolic disorders; Mice; Review; type 1 diabetes; Vaccination; Viral infections; Virus Diseases - complications; Virus Diseases - immunology; Virus Diseases - virology; viruses
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1111/j.1365-2249.2011.04554.x

Summary OTHER THEMES PUBLISHED IN THIS IMMUNOLOGY IN THE CLINIC REVIEW SERIES Metabolic diseases, host responses, cancer, autoinflammatory diseases, allergy. Convincing evidence now indicates that viruses are associated with type 1 diabetes (T1D) development and progression. Human enteroviruses (HEV) have emerged as prime suspects, based on detection frequencies around clinical onset in patients and their ability to rapidly hyperglycaemia trigger in the non‐obese diabetic (NOD) mouse. Whether or not HEV can truly cause islet autoimmunity or, rather, act by accelerating ongoing insulitis remains a matter of debate. In view of the disease's globally rising incidence it is hypothesized that improved hygiene standards may reduce the immune system's ability to appropriately respond to viral infections. Arguments in favour of and against viral infections as major aetiological factors in T1D will be discussed in conjunction with potential pathological scenarios. More profound insights into the intricate relationship between viruses and their autoimmunity‐prone host may lead ultimately to opportunities for early intervention through immune modulation or vaccination.