Type 1 Diabetes Center, The La Jolla Institute for Allergy and Immunology, La Jolla, CA 92037, USA.
Clin Exp Immunol. 2012 Apr;168(1):5-11. doi: 10.1111/j.1365-2249.2011.04554.x.
Convincing evidence now indicates that viruses are associated with type 1 diabetes (T1D) development and progression. Human enteroviruses (HEV) have emerged as prime suspects, based on detection frequencies around clinical onset in patients and their ability to rapidly hyperglycaemia trigger in the non-obese diabetic (NOD) mouse. Whether or not HEV can truly cause islet autoimmunity or, rather, act by accelerating ongoing insulitis remains a matter of debate. In view of the disease's globally rising incidence it is hypothesized that improved hygiene standards may reduce the immune system's ability to appropriately respond to viral infections. Arguments in favour of and against viral infections as major aetiological factors in T1D will be discussed in conjunction with potential pathological scenarios. More profound insights into the intricate relationship between viruses and their autoimmunity-prone host may lead ultimately to opportunities for early intervention through immune modulation or vaccination.
现在有令人信服的证据表明，病毒与 1 型糖尿病（T1D）的发生和发展有关。人类肠病毒（HEV）作为主要的嫌疑犯出现，这是基于在患者发病前后的检测频率及其在非肥胖型糖尿病（NOD）小鼠中迅速引发高血糖的能力。HEV 是否真的能引起胰岛自身免疫，还是通过加速正在进行的胰岛炎起作用，这仍然是一个有争议的问题。鉴于该疾病在全球的发病率不断上升，有人假设，卫生条件的改善可能会降低免疫系统对病毒感染的适当反应能力。本文将讨论病毒感染作为 T1D 主要病因的因素，并结合潜在的病理情况进行讨论。对病毒与其自身免疫倾向宿主之间复杂关系的更深入了解，可能最终为通过免疫调节或疫苗接种进行早期干预提供机会。
