Nurminen Noora, Oikarinen Sami, Hyöty Heikki
Department of Virology, School of Medicine, University of Tampere, Tampere, Finland.
Rev Diabet Stud. 2012 Winter;9(4):260-71. doi: 10.1900/RDS.2012.9.260. Epub 2012 Dec 28.
Environmental factors play an important role in the pathogenesis of type 1 diabetes, and are attractive targets for preventive interventions. Several studies have shown that viruses can cause diabetes in animals, indicating their potential as candidates for environmental triggering agents. However, human studies have been hampered by the complex nature of the disease pathogenesis, leaving the question of viral etiology unanswered. Significant progress has recently been made in this field by searching for viruses within pancreatic tissue samples, and by carrying out prospective studies. Consequently, there is increasing evidence for a group of enteroviruses acting as possible environmental key triggers. In past studies, these viruses have been linked to type 1 diabetes. Recent studies have shown that they exert tropism to pancreatic islets, and that they are associated with the start of the beta-cell damaging process. Also, polymorphisms of the gene coding for the innate immune system sensor for enteroviruses (IFIH1) were found to modulate the risk of diabetes. Based on these findings, interest in the possible development of vaccines against these viruses has increased. However, even if enterovirus vaccines (polio vaccines) are effective and safe, we currently lack necessary information for the development of a vaccine against diabetogenic enteroviruses, e.g. regarding the identification of their specific serotypes and the causal relationship between these viruses and diabetes initiation. Ongoing research projects are currently addressing these questions, and will hopefully increase the consensus in this field. Also, new sequencing technologies will provide additional information about the whole virome, which could enable the discovery of new candidate viruses.
环境因素在1型糖尿病的发病机制中起着重要作用，是预防性干预的有吸引力的目标。多项研究表明，病毒可在动物中引发糖尿病，表明它们作为环境触发因素的潜在可能性。然而，人类研究因疾病发病机制的复杂性而受阻，病毒病因问题仍未得到解答。最近，通过在胰腺组织样本中寻找病毒以及开展前瞻性研究，该领域取得了重大进展。因此，越来越多的证据表明一组肠道病毒可能是环境关键触发因素。在过去的研究中，这些病毒与1型糖尿病有关。最近的研究表明，它们对胰岛具有嗜性，并且与β细胞损伤过程的开始有关。此外，发现编码肠道病毒先天免疫系统传感器的基因（IFIH1）的多态性可调节糖尿病风险。基于这些发现，人们对开发针对这些病毒的疫苗的兴趣增加。然而，即使肠道病毒疫苗（脊髓灰质炎疫苗）有效且安全，我们目前仍缺乏开发针对致糖尿病肠道病毒疫苗的必要信息，例如关于其特定血清型的鉴定以及这些病毒与糖尿病发病之间的因果关系。正在进行的研究项目目前正在解决这些问题，有望在该领域增加共识。此外，新的测序技术将提供有关整个病毒组的更多信息，这可能有助于发现新的候选病毒。
