Enterovirus infections have been linked to T1D in several studies. Enteroviruses are small viruses that are directly or indirectly transmitted from person to person, initially infecting the intestinal tract. Fifty to eighty percent of enterovirus infections cause no symptoms and the virus can persist in the body after the initial infection is over. This study evaluated whether the lining of the intestinal tract is a reservoir for the persistence of enteroviruses in people with T1D. Small bowel samples from 39 T1D patients, 41 control subjects, and 40 celiac disease patients were analyzed for the presence of enteroviruses. Additionally, the presence of virus was compared with inflammatory markers such as T-cells or antibody deposits. Enterovirus was found in T1D patients more frequently than in control subjects and was associated with a clear inflammation response in the lining of the gut. T1D patients remained virus positive in follow-up samples taken after 12 months observation. These results suggest that a large proportion of T1D patients have persistent enterovirus infection associated with an inflammation process in the lining of their intestine.
Oikarinen M, Tauriainen S, Oikarinen S, Honkanen T, Collin P, Rantala I, Mäki M, Kaukinen K, Hyöty H. Type 1 diabetes is associated with enterovirus infection in gut mucosa. (2012) Diabetes. Mar;61(3):687-91.
Ramifications for Individuals with Type 1 Diabetes:
These findings support the theory that the lining of the intestinal tract is a reservoir for enteroviruses that persist in people with T1D. This persistent infection may produce a continuous inflammatory state that can spread to the pancreas and play a role in triggering the T1D disease process. Ultimately, if enteroviruses are proven to play a critical role in T1D, development of a vaccine or anti-viral agents that target the virus may be a possible T1D prevention strategy.
This study was partly funded by JDRF.