High titres of IgA antibodies to enterovirus in fulminant type-1 diabetes

Imagawa, Akihisa; Hanafusa, Toshiaki; Makino, Hideichi; Miyagawa, J-I; Juto, Per

doi:10.1007/s00125-004-1624-z

Cited by 78 publications

(41 citation statements)

References 10 publications

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“…In addition, IgA antibody titers to enterovirus were significantly higher in patients with recent-onset fulminant type 1 diabetes than in those with typical type 1A diabetes and controls [30]. In this study, the assay system was able to detect IgA antibodies reacting with several different serotypes of enterovirus such as coxsackie A, coxsackie B, and echoviruses.…”

Section: Virus-primary Candidate?mentioning

confidence: 70%

Pathogenesis of Fulminant Type 1 Diabetes

Imagawa¹,

Hanafusa²

2006

Rev Diabetic Stud

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■ AbstractFulminant type 1 diabetes is a new subtype of type 1 diabetes. The term was established in 2000. It is a syndrome characterized by a markedly rapid and almost complete destruction of pancreatic β-cells. Several lines of evidence suggest that both genetic factors, such as human leukocyte antigen (HLA), and environmental factors, such as viral infection, contribute to the development of this disease. It is also suggested that autoimmune processes contribute less critically to fulminant type 1 diabetes than to classic type 1A diabetes. Based on the findings made to date, both viral infection and the subsequent immune reaction in genetically susceptible individuals cause β-cell destruction and lead to fulminant type 1 diabetes.

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Section: Virus-primary Candidate?mentioning

confidence: 70%

Pathogenesis of Fulminant Type 1 Diabetes

Imagawa¹,

Hanafusa²

2006

Rev Diabetic Stud

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“…Although our study population only included a small number of patients with fulminant type 1 diabetes, an increased frequency of HLA-DR2 in fulminant type 1 diabetes compared with acute-onset type 1 diabetes was also detected by a nationwide survey performed in Japan (32). This difference in the frequency of HLA-DR2 between fulminant type 1 diabetes and type 1A diabetes may be due to a different pathogenesis of the former (37). In contrast, HLA-DR2 was protective against early complete ␤-cell destruction in type 1A diabetes, a result that was consistent with the findings of our previous cross-sectional study (21).…”

Section: Discussionmentioning

confidence: 82%

Combination of HLA-A24, -DQA1*03, and -DR9 Contributes to Acute-Onset and Early Complete β-Cell Destruction in Type 1 Diabetes

Nakanishi

Inoko

2006

Diabetes

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To elucidate the genetic factors contributing to heterogeneity of the rate of ␤-cell destruction in type 1 diabetes, we investigated the relationship between the time course of complete ␤-cell loss and HLA class I and II alleles. HLA allele frequencies were also examined among subgroups classified by the mode of onset. The subjects were 266 type 1 diabetic patients (among whom 196 patients were studied longitudinally) and 136 normal control subjects. Earlier complete loss of ␤-cell function was observed in patients who possessed both HLA-A24 and HLA-DQA1*03 and in patients who had HLA-DR9, compared with those without these HLA alleles (P ‫؍‬ 0.0057 and 0.0093, respectively). Much earlier complete ␤-cell loss was observed in the patients who possessed all of HLA-A24, -DQA1*03, and -DR9 compared with the remaining patients (P ‫؍‬ 0.0011). The combination of HLA-A24, -DQA1*03, and -DR9 showed a higher frequency in acute-onset than slow-onset type 1 diabetes (P ‫؍‬ 0.0002). In contrast, HLA-DR2 was associated with a slower rate of progression to complete ␤-cell loss. These results indicate that the combination of HLA-A24, -DQA1*03, and -DR9 contributes to the acute-onset and early complete ␤-cell destruction, whereas HLA-DR2 has a protective effect against complete ␤-cell loss in type 1 diabetes.

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“…Two case reports have described fulminant type 1 diabetes developing after the reactivation of human herpes virus-6 or infection with the herpes simplex virus [6][7]. Elevation of IgA antibodies to enterovirus has also been observed in patients with fulminant type 1 diabetes, suggesting that recurrent enterovirus infection may be one of the triggers for the development of fulminant type 1 diabetes [8]. Mumps virus has an affinity for the pancreas, and several reports have discussed the relationship between mumps infection and the onset of autoimmune (type 1A) diabetes [9].…”

Section: Discussionmentioning

confidence: 99%

A Case of Fulminant Type 1 Diabetes Associated With Significant Elevation of Mumps Titers

et al. 2008

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Abstract. Type 1 diabetes mellitus is classified as either autoimmune or idiopathic. Fulminant type 1 diabetes was originally reported as a subtype of idiopathic type 1 diabetes. Though involvement of viral infections has been suggested as a triggering mechanism, its pathogenesis remains unknown. Here, we present a case of fulminant type 1 diabetes associated with significant elevation of mumps titers. A 56-year-old Japanese man had suffered from nausea and generalized fatigue for two days before being transferred to our hospital in a confused state. Findings on admission revealed a high blood glucose level, near-normal HbA1c level, metabolic acidosis, and increased urinary ketone levels. Serum tests for islet-associated autoantibodies were negative. The serum, urinary C-peptide levels and the result of glucagon test indicated severe impairment of insulin secretion. These results were compatible with the diagnosis of fulminant type 1 diabetes. Also, he was suspected as having mumps infection on the basis of serological testing. These findings suggest that fulminant type 1 diabetes developed after mumps virus infection in our case. To the best of our knowledge, no other report has indicated an association between a recent mumps infection and the onset of fulminant type 1 diabetes. This case suggests an association between fulminant type 1 diabetes and mumps virus infection.

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High titres of IgA antibodies to enterovirus in fulminant type-1 diabetes

Cited by 78 publications

References 10 publications

Pathogenesis of Fulminant Type 1 Diabetes

Pathogenesis of Fulminant Type 1 Diabetes

Combination of HLA-A24, -DQA1*03, and -DR9 Contributes to Acute-Onset and Early Complete β-Cell Destruction in Type 1 Diabetes

A Case of Fulminant Type 1 Diabetes Associated With Significant Elevation of Mumps Titers

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