Study Supports Link Between Enterovirus Infection and Autoimmunity That Leads to Type 1 Diabetes

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) shows that children with type 1 diabetes (T1D) have a higher incidence of enterovirus infections prior to experiencing the autoimmune processes which lead to their T1D. The study is by Professor Heikki Hyöty and Dr. Hanna Honkanen, University of Tampere, Finland, and colleagues. Type 1 diabetes is caused by an immune-mediated process that damages insulin-producing beta cells in the pancreas. The subclinical phase of the disease can be identified by detecting autoantibodies. Enteroviruses have been linked to type 1 diabetes in studies showing an increased frequency of these viruses in the blood and pancreas of diabetic and autoantibody-positive individuals and in studies showing an increased frequency of enterovirus antibodies in people with T1D. However, this association has not been seen in all studies. In this new study, the authors analyzed whether the presence of enteroviruses in stools was associated with the appearance of islet autoimmunity in the "Type 1 Diabetes Prediction and Prevention Study" in Finland. The current study is the largest study to date in which enteroviruses have been analyzed in stool samples collected over time from children who developed signs of a beta cell-damaging process. A total of 1673 stool samples from 129 case children who turned positive for multiple islet autoantibodies and 3108 stool samples from 282 matched control children were screened for the presence of enterovirus ribonucleic acid (RNA - the genetic material found in some viruses). Altogether, 108 infections were diagnosed in the 129 case children and 169 infections in the 282 control children during the whole follow-up (mean 0.8 vs 0.6 infections per child).
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