Hyöty H, Taylor K W
Department of Virology, University of Tampere Medical School and Tampere, University Hospital, Lenkkeilijänkatu 10, 33520 Tampere, Finland.
Diabetologia. 2002 Oct;45(10):1353-61. doi: 10.1007/s00125-002-0852-3. Epub 2002 Aug 7.
Viruses have long been considered a major environmental factor in the aetiology of Type I (insulin-dependent) diabetes mellitus and recent work has greatly confirmed and extended this role. In addition to the enteroviruses, there are several other viruses which, from time to time, have been considered potential causal agents for human diabetes. With the exception of rubella, their role is not clear. The relation of enteroviruses with Type I diabetes has only been properly clarified by the use of new technologies, especially those based on polymerase chain reaction methods to identify them in blood. It is now evident from studies in several countries that enterovirus infection accompanies or precedes the onset of diabetes in many children. It is less certain whether this is true for older persons or for other types of diabetes. Enterovirus infection in pregnancy has also been suggested to cause diabetes in children. The infection with enteroviruses seems to be linked to the induction of islet-cell autoantibodies as well as to the expression of interferon-alpha. Both of these events are connected with islet-cell destruction. It has become increasingly important to establish the nature of the infecting virus in the early stages of diabetes. It seems likely that a number of viruses of the coxsackie or echovirus type are involved, although the nature of the nucleotide sequences responsible for diabetogenicity remains elusive.
长期以来，病毒一直被认为是Ⅰ型（胰岛素依赖型）糖尿病病因中的一个主要环境因素，最近的研究极大地证实并拓展了这一作用。除肠道病毒外，还有其他几种病毒，它们不时被认为是人类糖尿病的潜在致病因子。除风疹外，它们的作用尚不清楚。肠道病毒与Ⅰ型糖尿病的关系只是通过使用新技术才得以恰当阐明，尤其是那些基于聚合酶链反应方法在血液中识别它们的技术。现在从几个国家的研究中可以明显看出，肠道病毒感染在许多儿童糖尿病发病时伴随出现或在发病之前出现。对于老年人或其他类型的糖尿病是否也是如此，尚不太确定。也有人提出孕期感染肠道病毒会导致儿童患糖尿病。肠道病毒感染似乎与胰岛细胞自身抗体的诱导以及α干扰素的表达有关。这两个事件都与胰岛细胞破坏有关。在糖尿病早期确定感染病毒的性质变得越来越重要。虽然导致糖尿病的核苷酸序列的性质仍然难以捉摸，但似乎有多种柯萨奇病毒或埃可病毒类型的病毒参与其中。
