Enteroviruses have been connected to type 1 diabetes (T1D) in various studies. Our recent observations in different populations suggest that this association may be linked to specific enterovirus types, such as coxsackievirus B1 (CBV1). Now we expanded these studies by increasing the size of previous cohorts and adding new populations to screen neutralizing antibodies against a wide panel of different CBV1 strains in patients with newly diagnosed T1D and matched controls. The presence of such antibodies is a highly specific indicator of past CBV1 infection.
Subjects and methods
The study cohort included 340 children with newly diagnosed T1D and 340 matched controls recruited in England, Estonia, Finland, France, Greece, Lithuania and Sweden during the years 2001-2007 in the EU-funded VirDiab study. One control child was selected for each case child and matched for the sampling time, gender and country. Neutralizing antibodies were analysed from serum against 11 different wild-type CBV1 strains and one prototype CBV1 strain using a plaque assay. Presence of antibodies against at least one of these strains was taken as an indicator or past infection.
CBV1 antibodies were more frequent among diabetic children than in control children. Altogether 48 % of the case children and 38 % of the control children had antibodies against at least one of the CBV1 strains (OR=1.7, 95% CI 1.2-2.4; p=0.003). CBV1-associated risk was not related to HLA genotype, age or gender. Finnish children had a lower frequency of CBV1 antibodies than children in other countries (22% vs. 52%, p<0.001).
The results support previous studies confirming a risk association between CBV1 infections and T1D. This finding opens up new possibilities to study the mechanisms of enterovirus-induced beta-cell damage and explore the options to prevent T1D by a virus vaccine.
Funded by EU and the Academy of Finland