“…The gut virome is known to be associated with the initiation of T1D, in which many in vitro and in vivo studies identified a positive correlation between the acute viral infection and the development of T1D [ 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 ]. T1D-associated viruses include enteroviruses such as coxsackievirus B4 ( CV-B4 ) which is known to mediate a low-grade pancreatic inflammation by enhancing viral replication, affecting the expression of β cell differentiation proteins, and lowering the expression of mitochondrial antiviral signaling proteins leading to persistent infection [ 130 ]. CV-B4 is also known to lower the expression of HLA class I molecules at the surface of the infected pancreatic beta cells which are then targeted by the activated NK cells leading to cytolysis [ 120 , 130 , 131 ].…”