Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Clin Invest. 2011 Apr;121(4):1497-507. doi: 10.1172/JCI44005. Epub 2011 Mar 14.
Viral infections have been linked to the onset of type I diabetes (T1D), with viruses postulated to induce disease directly by causing β cell injury and subsequent release of autoantigens and indirectly via the host type I interferon (IFN-I) response triggered by the virus. Consistent with this, resistance to T1D is associated with polymorphisms that impair the function of melanoma differentiation associated gene-5 (MDA5), a sensor of viral RNA that elicits IFN-I responses. In animal models, triggering of another viral sensor, TLR3, has been implicated in diabetes. Here, we found that MDA5 and TLR3 are both required to prevent diabetes in mice infected with encephalomyocarditis virus strain D (EMCV-D), which has tropism for the insulin-producing β cells of the pancreas. Infection of Tlr3-/- mice caused diabetes due to impaired IFN-I responses and virus-induced β cell damage rather than T cell-mediated autoimmunity. Mice lacking just 1 copy of Mda5 developed transient hyperglycemia when infected with EMCV-D, whereas homozygous Mda5-/- mice developed severe cardiac pathology. TLR3 and MDA5 controlled EMCV-D infection and diabetes by acting in hematopoietic and stromal cells, respectively, inducing IFN-I responses at kinetically distinct time points. We therefore conclude that optimal functioning of viral sensors and prompt IFN-I responses are required to prevent diabetes when caused by a virus that infects and damages the β cells of the pancreas.
病毒感染与 1 型糖尿病(T1D)的发病有关,病毒被推测通过直接引起β细胞损伤和随后释放自身抗原,以及通过病毒触发的宿主 I 型干扰素(IFN-I)反应间接引起疾病。与此一致的是,T1D 的抗性与损害黑色素瘤分化相关基因-5(MDA5)功能的多态性有关,MDA5 是一种识别病毒 RNA 的传感器,可引发 IFN-I 反应。在动物模型中,另一种病毒传感器 TLR3 的触发被牵连到糖尿病中。在这里,我们发现 MDA5 和 TLR3 都需要在感染具有胰腺胰岛素产生β细胞亲嗜性的脑炎心肌炎病毒株 D(EMCV-D)的小鼠中预防糖尿病。由于 IFN-I 反应受损和病毒引起的β细胞损伤而不是 T 细胞介导的自身免疫,Tlr3-/- 小鼠的感染导致糖尿病。缺乏 1 个 MDA5 拷贝的小鼠在感染 EMCV-D 时会出现短暂的高血糖,而纯合 Mda5-/- 小鼠则会出现严重的心脏病理。TLR3 和 MDA5 通过分别在造血细胞和基质细胞中作用来控制 EMCV-D 感染和糖尿病,在不同的动力学时间点诱导 IFN-I 反应。因此,我们得出结论,当感染和损害胰腺β细胞的病毒引起糖尿病时,需要充分发挥病毒传感器的功能并迅速产生 IFN-I 反应。