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

Authors

  • K. T. Coppieters,

    1. Type 1 Diabetes Center, The La Jolla Institute for Allergy and Immunology, La Jolla, CA
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    • Current address: Unit for Molecular Immunology and Inflammation, Ghent University, Ghent, Belgium.

  • A. Wiberg,

    1. Type 1 Diabetes Center, The La Jolla Institute for Allergy and Immunology, La Jolla, CA
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  • S. M. Tracy,

    1. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
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  • M. G. von Herrath

    Corresponding author
    1. Type 1 Diabetes Center, The La Jolla Institute for Allergy and Immunology, La Jolla, CA
      M. G. von Herrath, Type 1 Diabetes Center, The La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA. E-mail: matthias@liai.org
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M. G. von Herrath, Type 1 Diabetes Center, The La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA. E-mail: matthias@liai.org

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.

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