Abstract
We found an association between the abundance of rodents in the wild and onset of type 1 diabetes (T1D) in humans. A picornavirus named Ljungan virus (LV) was subsequently isolated from wild bank voles. Both picornavirus-like particles detected by electron microscopy and LV antigen visualized by immunohistochemistry was seen in islets of Langerhans in diabetic wild bank voles. LV antigen has also been found in islets of Langerhans in a patient with recent onset of T1D and in the commonly used Bio Breeding (BB) T1D rat model. We discuss the possibility of T1D and type 2 diabetes (T2D) as parts of a single disease entity. Antiviral compounds directed against picornavirus have been found to be an effective treatment of diabetes in BB rats. We propose using the same currently available antiviral compounds in clinical trials in humans. Antiviral treatment would have the potential to be both proof of concept for involvement of a picornavirus in diabetes pathogenesis and also present a first-generation therapy.
Highlights
Despite extensive research effort, the body of evidence supporting a relationship between viral infections and type 1 diabetes (T1D) remains largely circumstantial [1,2]
Support for the hypothesis that a virus can cause T1D in humans includes the fact that strains of enteroviruses and encephalomyocarditis virus, both belonging to the picornavirus family, have the ability to induce or accelerate diabetes in animal models [3,4]
In this review we present data suggesting that a new group of rodent-born picornaviruses, namely the Ljungan virus, have the potential for explaining T1D in both animals and humans
Summary
The body of evidence supporting a relationship between viral infections and type 1 diabetes (T1D) remains largely circumstantial [1,2]. Support for the hypothesis that a virus can cause T1D in humans includes the fact that strains of enteroviruses and encephalomyocarditis virus, both belonging to the picornavirus family, have the ability to induce or accelerate diabetes in animal models [3,4]. The majority of reports on possible infectious etiology of T1D focus on picornavirus in general and enteroviruses in particular as playing a major role in development of T1D in humans. In this review we present data suggesting that a new group of rodent-born picornaviruses, namely the Ljungan virus (including Ljungan related viruses), have the potential for explaining T1D in both animals and humans. We summarize studies and data generated during the past two decades both for and against the hypothesis that Ljungan virus (LV) or related virus causes diabetes in animals and in humans. We introduce the idea of testing the hypothesis of picornavirus involvement in humans through antiviral clinical trials using compounds directed towards this viral family
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