Enterovirus infection may increase the risk for progression from islet autoimmunity to type 1 diabetes, a study has suggested.
The Diabetes and Autoimmunity Study in the Young was commissioned in 1993 to follow 2,365 American children who were genetically predisposed to diabetes for islet auto-immunity and progression to type 1 diabetes.
Marian Rewers, from the University of Colorado, and a team collected blood samples and rectal swabs from the children every three to six months from the age of nine months until 2004. The children were followed-up for seroconversion for islet auto-antibodies (islet auto-immunity) and subsequent conversion to type 1 diabetes.
Reverse transcriptase polymerase chain reaction was used on the serum and rectal swabs to detect the presence or absence of enteroviral RNA.
Overall, 140 children developed islet autoimmunity by the age of four on average. Of these, 50 went on to develop type 1 diabetes over an additional 4.2 years.
Detection of enteroviral RNA in serum, but not rectal swabs, was associated with a 7.02-fold increased risk for progressing to type 1 diabetes when islet autoimmunity was detected, after adjustment for number of auto-antibodies.
The research team cautioned that "enterovirus infection may be just one of many factors that can accelerate progression to diabetes, eg, through non-specific activation of autoreactive T-cells. Additional host and environmental factors are also likely to play a role."