Abstract
Objective Viruses trigger and promote islet cell destruction and cause type 1 diabetes mellitus (T1DM). However, the existence of a cause-and-effect relationship is under debate. The aim of this study is to investigate the sero-epidemiological and molecular evidence on enteroviruses and respiratory viruses in patients with newly diagnosed T1DM during the cold season. Design Forty children newly diagnosed with T1DM and 30 healthy children who presented to the clinic over the course of a year were included in the study. The IgM antibodies against enteroviruses and respiratory viruses were studied using the indirect immunofluorescence assay (IFA) test, and no CBV4-specific RNA was detected in the children. The onset times of T1DM were classified into fall-winter and spring-summer seasons and separated into cold, moderate, or warm months in terms of temperature. Results The percentages of viral IgM antibodies against most common viruses were detected in the patients as follows: influenza B (IVB) (70%), echovirus 7 (ECHO7) (45%), parainfluenza virus 4 (PIV4) (40%), coxsackievirus A7 (CAV7) (27.5%), and H3N2 (22.5%). Compared with the control group, the above viruses had a significant association with T1DM (p ≤ 0.001, p ≤ 0.001, p = 0.035, p = 0.003, and p = 0.023, resp.). CBV4-specific RNA was not detected in any serum. A total of 75% and 95% patients were diagnosed with T1DM in the fall-winter seasons and cold-moderate months, respectively. Conclusion Our study demonstrates the significant association between T1DM and the presence of IgM antibodies against IVB, ECHO7, PIV4, CAV7, and H3N2, and the majority of newly diagnosed T1DM appeared in the fall-winter season. It suggests that enteroviruses and respiratory viruses, in addition to seasonal variation, could play a role in the etiopathogenesis and clinical onset of T1DM.
Highlights
Many studies in recent decades have determined that enteroviruses (EV), in particular, and respiratory viruses play a role in the pathogenesis of type 1 diabetes (T1DM) [1,2,3]
The present study demonstrates that the time of the onset of newly diagnosed type 1 diabetes mellitus (T1DM) coincided with the fall-winter season, which is the typical season for respiratory tract viruses, and T1DM patients had an association with respiratory viruses and enteroviruses including Influenza virus B (IVB), echovirus 7 (ECHO7), parainfluenza virus 4 (PIV4), coxsackievirus A7 (CAV7), and H3N2 at the clinical onset
These results indicate that enteroviruses and respiratory tract viruses, in addition to seasonal variation, could play a role in the etiopathogenesis and clinical onset of T1DM
Summary
Many studies in recent decades have determined that enteroviruses (EV), in particular, and respiratory viruses play a role in the pathogenesis of type 1 diabetes (T1DM) [1,2,3]. Respiratory viruses share common clinical and pathological characteristics with enteroviruses. These viruses can grow in either the respiratory or intestinal tract. In experimental and epidemiologic studies, it has been shown that influenza viruses can affect islet cells [4, 5]. Viruses lead to beta cell destruction through indirect or direct pathways [6, 7]. These patterns are known as T1a (autoimmune) and T1b (nonimmune or cytopathic)
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