Skip to main content

Advertisement

Log in

Virus Infections and Type 1 Diabetes Risk

  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Common intestinal infections caused by human enteroviruses (HEVs) are considered major environmental factors predisposing to type 1 diabetes (T1D). In spite of the active research of the field, the HEV-induced pathogenetic processes are poorly understood. Recently, after the first documented report on HEV infections in the pancreatic islets of deceased T1D patients, several groups became interested in the issue and studied valuable human material, the autopsy pancreases of diabetic and/or autoantibody-positive patients for HEV infections. In this review, the data on HEV infections in human pancreatic islets are discussed with special reference to the methods used. Likewise, mechanisms that could increase viral access to the pancreas are reviewed and discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Hober D, Sauter P: Pathogenesis of type 1 diabetes mellitus: interplay between enterovirus and host. Nat Rev Endocrinol 2010, 6:279–289.

    Article  PubMed  Google Scholar 

  2. Roivainen M: Enteroviruses: new findings on the role of enteroviruses in type 1 diabetes. Int J Biochem Cell Biol 2006, 38:721–725.

    Article  CAS  PubMed  Google Scholar 

  3. Tauriainen S, Oikarinen S, Oikarinen M, Hyoty H: Enteroviruses in the pathogenesis of type 1 diabetes. Semin Immunopathol 2010 Apr 28 [Epub ahead of print].

  4. Richer MJ, Horwitz MS: Coxsackievirus infection as an environmental factor in the etiology of type 1 diabetes. Autoimmun Rev 2009, 8:611–615.

    Article  CAS  PubMed  Google Scholar 

  5. Richer MJ, Horwitz MS: The innate immune response: an important partner in shaping coxsackievirus-mediated autoimmunity. J Innate Immun 2009, 1:421–434.

    Article  CAS  PubMed  Google Scholar 

  6. Filippi CM, von Herrath MG: 99th Dahlem conference on infection, inflammation and chronic inflammatory disorders: viruses, autoimmunity and immunoregulation. Clin Exp Immunol 2010, 160:113–119.

    Article  CAS  PubMed  Google Scholar 

  7. King AM, Brown F, Christian P, et al.: Picornaviridae. In Virus Taxonomy: Seventh Report of the International Committee on Taxonomy of Viruses. Edited by Van Regenmortel MH, Fauquet, CM, Bishop DH, et al. San Diego, CA: Academic Press; 2000:657–678.

    Google Scholar 

  8. Oberste MS, Maher K, Kilpatrick DR, et al.: Typing of human enteroviruses by partial sequencing of VP1. J Clin Microbiol 1999, 37:1288–1293.

    CAS  PubMed  Google Scholar 

  9. Yoon JW, Austin M, Onodera T, Notkins AL: Isolation of a virus from the pancreas of a child with diabetic ketoacidosis. N Engl J Med 1979, 300:1173–1179.

    Article  CAS  PubMed  Google Scholar 

  10. Yoon JW, Notkins AL: Virus-induced diabetes in mice. Metabolism 1983, 32:37–40.

    Article  CAS  PubMed  Google Scholar 

  11. Klingel K, Stephan S, Sauter M, et al.: Pathogenesis of murine enterovirus myocarditis: virus dissemination and immune cell targets. J Virol 1996, 70:8888–8895.

    CAS  PubMed  Google Scholar 

  12. Ylipaasto P, Klingel K, Lindberg AM, et al.: Enterovirus infection in human pancreatic islet cells, islet tropism in vivo and receptor involvement in cultured islet beta cells. Diabetologia 2004, 47:225–239.

    Article  CAS  PubMed  Google Scholar 

  13. •• Dotta F, Censini S, van Halteren AG, et al.: Coxsackie B4 virus infection of beta cells and natural killer cell insulitis in recent-onset type 1 diabetic patients. Proc Natl Acad Sci U S A 2007, 104:5115–5120. This paper provides evidence for the presence of enteroviruses in pancreatic islets.

    Article  CAS  PubMed  Google Scholar 

  14. •• Richardson SJ, Willcox A, Bone AJ, et al.: The prevalence of enteroviral capsid protein vp1 immunostaining in pancreatic islets in human type 1 diabetes. Diabetologia 2009, 52:1143–1151. This paper provides evidence for the presence of enteroviruses in pancreatic islets.

    Article  CAS  PubMed  Google Scholar 

  15. •• Oikarinen M, Tauriainen S, Honkanen T, et al.: Analysis of pancreas tissue in a child positive for islet cell antibodies. Diabetologia 2008, 51:1796–1802. This paper provides evidence for the presence of enteroviruses in pancreatic islets.

    Article  CAS  PubMed  Google Scholar 

  16. •• Shibasaki S, Imagawa A, Tauriainen S, et al.: Expression of toll-like receptors in the pancreas of recent-onset fulminant type 1 diabetes. Endocr J 57:211–219. This paper provides evidence for the presence of enteroviruses in pancreatic islets.

  17. •• Tanaka S, Nishida Y, Aida K, et al.: Enterovirus infection, CXC chemokine ligand 10 (CXCL10), and CXCR3 circuit: a mechanism of accelerated beta-cell failure in fulminant type 1 diabetes. Diabetes 2009, 58:2285–2291. This paper provides evidence for the presence of enteroviruses in pancreatic islets.

    Article  CAS  PubMed  Google Scholar 

  18. Klingel K: Molecular biologic detection of virus infection in myocarditis and dilated cardiomyopathy. In Myocarditis. Edited by Cooper LT. Totowa, NJ: Humana Press; 2002:295–324.

    Chapter  Google Scholar 

  19. Oikarinen M, Tauriainen S, Penttila P, et al.: Evaluation of immunohistochemistry and in situ hybridization methods for the detection of enteroviruses using infected cell culture samples. J Clin Virol 47:224–228.

  20. Klingel K, Sauter M. Bock CT, et al.: Molecular pathology of inflammatory cardiomyopathy. Med Microbiol Immunol 2004, 193:101–107.

    Article  CAS  PubMed  Google Scholar 

  21. •• Roivainen M, Klingel K: Role of enteroviruses in the pathogenesis of type 1 diabetes. Diabetologia 2009, 52:995–996. This paper provides evidence for the presence of enteroviruses in pancreatic islets.

    Article  CAS  PubMed  Google Scholar 

  22. Harkonen T, Lankinen H, Davydova B, et al.: Enterovirus infection can induce immune responses that cross-react with beta-cell autoantigen tyrosine phosphatase IA-2/IAR. J Med Virol 2002, 66:340–350.

    Article  CAS  PubMed  Google Scholar 

  23. Harkonen T, Puolakkainen M, Sarvas M, et al.: Picornavirus proteins share antigenic determinants with heat shock proteins 60/65. J Med Virol 2000, 62:383–391.

    Article  CAS  PubMed  Google Scholar 

  24. Bussolati G, Leonardo E: Technical pitfalls potentially affecting diagnoses in immunohistochemistry. J Clin Pathol 2008, 61:1184–1192.

    Article  CAS  PubMed  Google Scholar 

  25. Ylipaasto P, Kutlu B, Rasilainen S, et al.: Global profiling of coxsackievirus- and cytokine-induced gene expression in human pancreatic islets. Diabetologia 2005, 48:1510–1522.

    Article  CAS  PubMed  Google Scholar 

  26. Ortis F, Naamane N, Flamez D, et al.: Cytokines interleukin-1beta and tumor necrosis factor-alpha regulate different transcriptional and alternative splicing networks in primary beta-cells. Diabetes 59:358–374.

  27. • Schulte BM, Kramer M, Ansems M, et al.: Phagocytosis of enterovirus-infected pancreatic beta-cells triggers innate immune responses in human dendritic cells. Diabetes 59:1182–1191. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

  28. • Schulte BM, Bakkers J, Lanke KH, et al.: Detection of enterovirus RNA in peripheral blood mononuclear cells of type 1 diabetic patients beyond the stage of acute infection. Viral Immunol 23:99–104. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

  29. Skarsvik S, Puranen J, Honkanen J, et al.: Decreased in vitro type 1 immune response against coxsackie virus B4 in children with type 1 diabetes. Diabetes 2006, 55:996–1003.

    Article  CAS  PubMed  Google Scholar 

  30. Hober D, Chehadeh W, Bouzidi A, Wattre P: Antibody-dependent enhancement of coxsackievirus B4 infectivity of human peripheral blood mononuclear cells results in increased interferon-alpha synthesis. J Infect Dis 2001, 184:1098–1108.

    Article  CAS  PubMed  Google Scholar 

  31. Chehadeh W, Lobert PE, Sauter P, et al.: Viral protein VP4 is a target of human antibodies enhancing coxsackievirus B4- and B3-induced synthesis of alpha interferon. J Virol 2005, 79:13882–13891.

    Article  CAS  PubMed  Google Scholar 

  32. • Sauter P, Chehadeh W, Lobert PE, et al.: A part of the VP4 capsid protein exhibited by coxsackievirus B4 E2 is the target of antibodies contained in plasma from patients with type 1 diabetes. J Med Virol 2008, 80:866–878. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

    Article  CAS  PubMed  Google Scholar 

  33. Ylipaasto P, Eskelinen M, Salmela K, et al.: Vitronectin receptors, alpha v integrins, are recognized by several non-RGD-containing echoviruses in a continuous laboratory cell line and also in primary human Langerhans’ islets and endothelial cells. J Gen Virol 91:155–165.

  34. • Oikarinen M, Tauriainen S, Honkanen T, et al.: Detection of enteroviruses in the intestine of type 1 diabetic patients. Clin Exp Immunol 2008, 151:71–75. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

    Article  CAS  PubMed  Google Scholar 

  35. • Vaarala O: Leaking gut in type 1 diabetes. Curr Opin Gastroenterol 2008, 24:701–706. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

    Article  PubMed  Google Scholar 

  36. • Minor P: Vaccine-derived poliovirus (VDPV): impact on poliomyelitis eradication. Vaccine 2009, 27:2649–2652. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

    Article  PubMed  Google Scholar 

  37. Roivainen M, Ylipaasto P, Savolainen C, et al.: Functional impairment and killing of human beta cells by enteroviruses: the capacity is shared by a wide range of serotypes, but the extent is a characteristic of individual virus strains. Diabetologia 2002, 45:693–702.

    Article  CAS  PubMed  Google Scholar 

  38. Al-Hello H, Davydova B, Smura T, et al.: Phenotypic and genetic changes in coxsackievirus B5 following repeated passage in mouse pancreas in vivo. J Med Virol 2005, 75:566–574.

    Article  CAS  PubMed  Google Scholar 

  39. • Al-Hello H, Paananen A, Eskelinen M, et al.: An enterovirus strain isolated from diabetic child belongs to a genetic subcluster of echovirus 11, but is also neutralised with monotypic antisera to coxsackievirus A9. J Gen Virol 2008, 89:1949–1959. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

    Article  CAS  PubMed  Google Scholar 

  40. • Al-Hello H, Ylipaasto P, Smura T, et al.: Amino acids of Coxsackie B5 virus are critical for infection of the murine insulinoma cell line, MIN-6. J Med Virol 2009, 81:296–304. This paper provides evidence for the mechanisms by which enterovirus infections might be involved in the pathogenesis of T1D.

    Article  CAS  PubMed  Google Scholar 

  41. Kang Y, Chatterjee NK, Nodwell MJ, Yoon JW: Complete nucleotide sequence of a strain of coxsackie B4 virus of human origin that induces diabetes in mice and its comparison with nondiabetogenic coxsackie B4 JBV strain. J Med Virol 1994, 44:353–361.

    Article  CAS  PubMed  Google Scholar 

  42. Paananen A, Ylipaasto P, Rieder E, et al.: Molecular and biological analysis of echovirus 9 strain isolated from a diabetic child. J Med Virol 2003, 69:529–537.

    Article  CAS  PubMed  Google Scholar 

  43. Titchener PA, Jenkins O, Szopa TM, et al.: Complete nucleotide sequence of a beta-cell tropic variant of coxsackievirus B4. J Med Virol 1994, 42:369–373.

    Article  CAS  PubMed  Google Scholar 

  44. Williams CH, Oikarinen S, Tauriainen S, et al.: Molecular analysis of an echovirus 3 strain isolated from an individual concurrently with appearance of islet cell and IA-2 autoantibodies. J Clin Microbiol 2006, 44:441–448.

    Article  CAS  PubMed  Google Scholar 

  45. Blomqvist S, Klemola P, Kaijalainen S, et al.: Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. J Clin Virol 48:49–54.

  46. Blomqvist S, Paananen A, Savolainen-Kopra C, et al.: Eight years of experience with molecular identification of human enteroviruses. J Clin Microbiol 2008, 46:2410–2413.

    Article  PubMed  Google Scholar 

  47. Palacios G, Oberste MS: Enteroviruses as agents of emerging infectious diseases. J Neurovirol 2005, 11:424–433.

    Article  CAS  PubMed  Google Scholar 

  48. Wikswo ME, Khetsuriani N, Fowlkes AL, et al.: Increased activity of Coxsackievirus B1 strains associated with severe disease among young infants in the United States, 2007–2008. Clin Infect Dis 2009, 49:e44–51.

    Article  PubMed  Google Scholar 

  49. Cabrerizo M, Echevarria JE, Otero A, et al.: Molecular characterization of a coxsackievirus A24 variant that caused an outbreak of acute haemorrhagic conjunctivitis in Spain, 2004. J Clin Virol 2008, 43:323–327.

    Article  CAS  PubMed  Google Scholar 

  50. Ding NZ, Wang XM, Sun SW, et al.: Appearance of mosaic enterovirus 71 in the 2008 outbreak of China. Virus Res 2009, 145:157–161.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgment

This work is supported by grants from the European Union (EP7-HEALTH-2007, DIAPREPP N202013), the Juvenile Diabetes Research Foundation (USA), The Academy of Finland, and the SFB-TR19 from the Deutsche Forschungsgemeinschaft (DFG).

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Merja Roivainen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roivainen, M., Klingel, K. Virus Infections and Type 1 Diabetes Risk. Curr Diab Rep 10, 350–356 (2010). https://doi.org/10.1007/s11892-010-0139-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11892-010-0139-x

Keywords

Navigation