The relationship between Coxsackie-B-virus-specific IgG responses and genetic factors (HLA-DR, GM, KM) in insulin-dependent diabetes mellitus.

IgG antibody titres to Coxsackie B1-B6 were measured in 113 insulin-dependent diabetes mellitus (IDDM) patients whose mean age was 12.2 years and mean duration of IDDM was 4.6 years, and in 87 normal sibling controls whose mean age was 13.8 years. Compared with their normal siblings, the diabetics had a significantly increased frequency of high response (titre greater than or equal to 320) to Coxsackie B2 (8% versus 1%, p = 0.028), to Coxsackie B4 (15% versus 1%, p = 0.0006), and to Coxsackie B viruses in general (25% versus 5%, p = 0.0001). The frequencies of HLA-DR and immunoglobulin (GM, KM) antigens did not differ between diabetics with and without a high response to Coxsackie B2, B4, or B viruses in general. We conclude that there is an association between IDDM and IgG response to Coxsackie B2, B4, and B viruses in general, a finding which is consistent with the interpretation that infection with Coxsackie B viruses, especially B4, may initiate the development of IDDM in a portion of individuals who have HLA-DR region susceptibility genes.