Can enteroviruses cause type 1 diabetes?

Enterovirus infections have long been considered as one possible environmental trigger of type 1 diabetes. These viruses have been detected from diabetic patients more often than from control subjects and they can infect beta cells in cell culture and induce diabetes in animal models. Furthermore, a same kind of seasonality has been observed in both the onset of clinical diabetes and subclinical beta cell autoimmunity (appearance of autoantibodies) as in enterovirus infections. Recently, considerable new evidence has cumulated from prospective studies indicating the risk effect of enterovirus infections long before clinical diabetes was diagnosed. In addition, several studies have reported enterovirus genome sequences in diabetic patients more often than in control subjects. Currently, the evidence for the role of enteroviruses is stronger than for most other environmental agents, but still the final proof is lacking. The ongoing studies aim to prove the risk effect in different populations and to identify the underlying mechanisms. This research field is becoming more and more important because it could open up possibilities to prevent type 1 diabetes by an enterovirus vaccine.