Enteroviruses and Type 1 Diabetes: Multiple Mechanisms and Factors?

Authors

Richard E Lloyd
Manasi Tamhankar
Åke Lernmark

Publication Date

1-27-2022

Journal

Annual Review of Medicine

DOI

10.1146/annurev-med-042320-015952

PMID

34794324

PMCID

PMC9242008

PubMedCentral® Posted Date

1-27-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Autoimmunity, Diabetes Mellitus, Type 1, Enterovirus, Enterovirus Infections, Humans, Insulin-Secreting Cells, type 1 diabetes, enterovirus, islet autoimmunity, persistent infection

Abstract

Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by insulin deficiency and resultant hyperglycemia. Complex interactions of genetic and environmental factors trigger the onset of autoimmune mechanisms responsible for development of autoimmunity to β cell antigens and subsequent development of T1D. A potential role of virus infections has long been hypothesized, and growing evidence continues to implicate enteroviruses as the most probable triggering viruses. Recent studies have strengthened the association between enteroviruses and development of autoimmunity in T1D patients, potentially through persistent infections. Enterovirus infections may contribute to different stages of disease development. We review data from both human cohort studies and experimental research exploring the potential roles and molecular mechanisms by which enterovirus infections can impact disease outcome.