Background: As one of the natural perturbants, infection with cytomegalovirus (CMV) is believed to play a role in the development of Type I diabetes. Using the DP-BB rat model for autoimmune diabetes, we here report about possible mechanisms responsible for R(at)CMV-induced accelerated onset of diabetes.Methods: Rats were i.p. infected with 2 £ 10 6 plaque forming units (pfu) RCMV and followed for diabetes development. Presence of RCMV antigens and DNA was analyzed by immunohistochemistry and PCR on pancreatic tissue and isolated islets. The effect of viral infection on peritoneal macrophages (pMF) and diabetes development was studied by analyzing numbers of pMF, virus permissiveness and by depletion of this subset by peritoneal lavage.Results: RCMV accelerated onset of diabetes without infecting pancreatic islets. Immunohistochemistry and PCR on pancreas and isolated islets indicated that islets are non-permissive for RCMV. Infection results in an influx of pMF 1 day p.i. of which ,0.05% showed signs of reproductive infection. Depletion of pMF on days 1 -3 p.i. completely counteracted the accelerating effect of RCMV.Interpretation: RCMV accelerates onset of diabetes without infecting pancreatic islets. pMF might function as an carriage to disseminate virus to the pancreas where they enhance activation of autoreactive T cells resulting in accelerated onset of diabetes.Keywords: BB rats; Cytomegalovirus; Diabetes; Macrophages; RCMV; Virus
INTRODUCTIONType 1 diabetes or Insulin Dependent Diabetes Mellitus (IDDM) (accounting for 10% of all cases of diabetes) is an organ-specific autoimmune disease, which results from the selective destruction of pancreatic b-cells. This destruction is histologically characterized by an inflammatory infiltrate around or within the islets (insulitis) containing large numbers of mononuclear cells and CD8 þ T cells (Notkins and Lernmark, 2001). Clinically, Type 1 diabetes presents as rapid onset polyuria, polydipsia, polyphagia, weight loss and hyperglycaemia .Although genetic factors are believed to be an important component in the pathogenesis of Type 1 diabetes (She, 1996;Field, 2002), also non-genetic factors appear to be required for disease onset since concordance rates among identical twins are only 30 -50% (Redondo et al., 2001). Among the non-genetic factors, viral infections are one of the leading candidate agents involved in the pathogenesis of Type 1 diabetes and a variety of different human viruses have been reported to be associated with human Type 1 diabetes, including CoxsackieB virus, rubella virus, mumps virus and several Herpesviridae (Jun and Yoon, 2001). Cytomegalovirus (CMV), a double stranded DNA virus belonging to the b-herpes virus family, is one of the Herpesviridae thought to be involved in the pathogenesis of Type 1 diabetes. This widespread virus (seropositivity varies from 60 to 90%) (Numazaki, 1997) causes latent and persistent infection without clinical symptoms in the immunocompetent host. In the immunocompromised host, however, primary infections and r...