a Faculty of Medicine and Life Sciences, Department of Virology , University of Tampere , Tampere , Finland.
b Fimlab Laboratories , Pirkanmaa Hospital District , Tampere , Finland.
Expert Rev Vaccines. 2018 Dec;17(12):1071-1083. doi: 10.1080/14760584.2018.1548281. Epub 2018 Nov 29.
Virus infections have long been considered as a possible cause of type 1 diabetes (T1D). One virus group, enteroviruses (EVs), has been studied extensively, and clinical development of a vaccine against T1D-associated EV types has started.
Epidemiological studies have indicated an association between EVs and T1D. These viruses have a strong tropism for insulin-producing β-cells; the destruction of these cells leads to T1D. The exact mechanisms by which EVs could cause T1D are not known, but direct infection of β-cells and virus-induced inflammation may play a role. Recent studies have narrowed down the epidemiological association to a subset of EVs: group B coxsackieviruses (CVBs). These findings have prompted efforts to develop vaccines against CVBs. Prototype CVB vaccines have prevented both infection and CVB-induced diabetes in mice. This review summarizes recent progress in the field and the specifics of what could constitute the first human vaccine developed for a chronic autoimmune disease.
Manufacturing of a clinical CVB vaccine as well as preclinical studies are currently in progress in order to enable clinical testing of the first CVB vaccine. Ongoing scientific research projects can significantly facilitate this effort by providing insights into the mechanisms of the CVB-T1D association.
病毒感染长期以来被认为是 1 型糖尿病(T1D)的可能病因之一。肠道病毒(EVs)作为一个病毒家族,受到了广泛的研究,针对与 T1D 相关的 EV 型的疫苗也已经开始临床开发。
流行病学研究表明 EVs 与 T1D 之间存在关联。这些病毒对产生胰岛素的β细胞具有很强的嗜性;这些细胞的破坏导致 T1D。EVs 如何引起 T1D 的确切机制尚不清楚,但β细胞的直接感染和病毒引起的炎症可能起作用。最近的研究将这种流行病学关联缩小到一组 EVs:B 组柯萨奇病毒(CVBs)。这些发现促使人们努力开发针对 CVBs 的疫苗。原型 CVB 疫苗可预防小鼠感染和 CVB 引起的糖尿病。这篇综述总结了该领域的最新进展,以及可能成为首个针对慢性自身免疫性疾病开发的人类疫苗的具体内容。
为了能够对首个 CVB 疫苗进行临床试验,目前正在制造临床用 CVB 疫苗并进行临床前研究。正在进行的科学研究项目可以通过深入了解 CVB-T1D 关联的机制,为这一努力提供重要帮助。