medwireNews: Research suggests that if enteroviruses do indeed contribute to the pathology of type 1 diabetes, then there is a large time lag between infection and the first damaging effects on beta cells.
In the case–control study, the 129 cases had an excess of enterovirus infections more than 1 year prior to developing islet autoantibodies, compared with 282 matched controls, at 6.3 versus 2.1 infections per 10 follow-up years. There was no difference in infection rates closer to the time of autoantibody development.
All children in the study, which Hanna Honkanen (University of Tampere, Finland) and co-researchers say is the largest to date, had HLA class II genotypes known to confer increased susceptibility to type 1 diabetes. Enterovirus infection was ascertained using prospectively collected stool samples – 1673 from the cases and 3108 from the controls.
This time lag was longer than the researchers found in a previous study, and other clinical and animal studies have not provided a consistent estimate of the delay between infection and any autoimmune effects.
“In any case, the present study argues against a rapid lytic effect of enteroviruses on beta cells, but rather suggests a possible involvement of viral persistence and/or immune-mediated mechanisms in enterovirus-induced diabetes in humans,” they write in Diabetologia.
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