Live attenuated enterovirus vaccine (OPV) is not associated with islet autoimmunity in children with genetic susceptibility to type 1 diabetes: prospective cohort study

Viskari, Hanna; Oikarinen, Sami; Hoppu, Sanna; Vuorinen, Tytti; Toppari, Jorma; Veijola, Riitta; Ilonen, Jorma; Knip, Mikael; Hyöty, Heikki

doi:10.1007/s00125-017-4410-4

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…28 29 Administration of oral poliovirus vaccine may increase the detection of enterovirus in stool samples, but this cohort received inactivated poliovirus vaccine injections. 30 31…”

Section: Discussionmentioning

confidence: 99%

Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort

Kahrs

Chudá

Tapia

et al. 2019

BMJ

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ObjectiveTo determine whether infection with human enterovirus or adenovirus, both common intestinal viruses, predicts development of coeliac disease.DesignCase-control study nested within Norwegian birth cohort recruited between 2001 and 2007 and followed to September 2016.SettingNorwegian population.ParticipantsChildren carrying the HLA genotype DR4-DQ8/DR3-DQ2 conferring increased risk of coeliac disease.ExposuresEnterovirus and adenovirus detected using real time polymerase chain reaction in monthly stool samples from age 3 to 36 months.Main outcome measureCoeliac disease diagnosed according to standard criteria. Coeliac disease antibodies were tested in blood samples taken at age 3, 6, 9, and 12 months and then annually. Adjusted odds ratios from mixed effects logistic regression model were used to assess the relation between viral infections before development of coeliac disease antibodies and coeliac disease.ResultsAmong 220 children, and after a mean of 9.9 (SD 1.6) years, 25 children were diagnosed as having coeliac disease after screening and were matched to two controls each. Enterovirus was found in 370 (17%) of 2135 samples and was significantly more frequent in samples collected before development of coeliac disease antibodies in cases than in controls (adjusted odds ratio 1.49, 95% confidence interval 1.07 to 2.06; P=0.02). The association was restricted to infections after introduction of gluten. High quantity samples (>100 000 copies/μL) (adjusted odds ratio 2.11, 1.24 to 3.60; P=0.01) and long lasting infections (>2 months) (2.16, 1.16 to 4.04; P=0.02) gave higher risk estimates. Both the commonly detected enterovirus species Enterovirus A and Enterovirus B were significantly associated with coeliac disease. The association was not found for infections during or after development of coeliac disease antibodies. Adenovirus was not associated with coeliac disease.ConclusionsIn this longitudinal study, a higher frequency of enterovirus, but not adenovirus, during early childhood was associated with later coeliac disease. The finding adds new information on the role of viral infections in the aetiology of coeliac disease.

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“…28 29 Administration of oral poliovirus vaccine may increase the detection of enterovirus in stool samples, but this cohort received inactivated poliovirus vaccine injections. 30 31…”

Section: Discussionmentioning

confidence: 99%

Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort

Kahrs

Chudá

Tapia

et al. 2019

BMJ

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“…Enterovirus appears to occur year-round with higher prevalence in late spring throughout early autumn [ 20 ]. Besides, the high rate of enterovirus detection might be due to the administration of live oral poliovirus vaccine (OPV) that caused increased enterovirus detected in stool samples [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Burden and etiology of moderate and severe diarrhea in children less than 5 years of age living in north and south of China: Prospective, population-based surveillance

et al. 2021

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Background Diarrhea remains the leading cause of childhood illness in China. Better understanding of burden and etiology of diarrheal diseases is important for development of effective prevention measures. Methods Population-based diarrhea surveillance was conducted in Sanjiang (southern China) year-round and Zhengding (northern China) in autumn/winter. Stool specimens were collected from children < 5 years of age experiencing diarrhea. The TaqMan Array Card (TAC), based on multiplex real-time PCR, was applied to detect multiple enteric microbial agents simultaneously. Results using these methods were compared to those derived from conventional PCR assays. Results During the study period, 6,380 children in Zhengding and 3,581 children in Sanjiang < 5 years of age participated. Three hundred and forty (31.2%) and 279 (22.9%) diarrhea episodes were identified as moderate-to-severe in the two counties, with incidence of 60.4 and 88.3 cases per 1,000 child-years in Zhengding and Sanjiang, respectively. The five most frequently detected bacterial and viral agents in Sanjiang were adenovirus, enterovirus, enteroaggregative Escherichia coli (EAEC), rotavirus, and sapovirus all the year round, while the most common viral agents in Zhengding were rotavirus, followed by astrovirus and adenovirus during the cool season. Compared to conventional PCR assay, the average incremental detection via the TAC method was twofold. Conclusion Our study demonstrated high diversity and prevalence of multiple major bacterial and viral agents, including rotavirus and calicivirus, among children in China. Further studies are needed to define the public health significance of neglected but frequently detected pathogens such as EAEC, enterotoxigenic E. coli, Campylobacter, adenovirus, and enterovirus.

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“…Previous studies have suggested that such epitopes may exist, but their role in the pathogenesis of T1D remains elusive [116]. A clinical vaccine candidate should ideally avoid these epitopes, even if the inactivated CVB vaccine does not exaggerate the development of diabetes in NOD mouse [107], and there are no indications that polio vaccines could cause diabetes, even when children with increased genetic susceptibility to T1D were vaccinated [117]. In addition, maternal antibodies against CVBs in cord blood do not increase the risk of T1D in the child arguing against the role of antibody mediated cross-reactivity [76].…”

Section: Preclinical Development Of a Cvb Vaccine Against T1dmentioning

confidence: 99%

Developing a vaccine for type 1 diabetes by targeting coxsackievirus B

Hyöty

León²,

Knip

2018

Expert Review of Vaccines

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Introduction: Virus infections have long been considered as a possible cause of type 1 diabetes (T1D). One virus group, enteroviruses (EVs), has been studied extensively, and clinical development of a vaccine against T1D-associated EV types has started. Areas covered: Epidemiological studies have indicated an association between EVs and T1D. These viruses have a strong tropism for insulin-producing β-cells; the destruction of these cells leads to T1D. The exact mechanisms by which EVs could cause T1D are not known, but direct infection of β-cells and virus-induced inflammation may play a role. Recent studies have narrowed down the epidemiological association to a subset of EVs: group B coxsackieviruses (CVBs). These findings have prompted efforts to develop vaccines against CVBs. Prototype CVB vaccines have prevented both infection and CVB-induced diabetes in mice. This review summarizes recent progress in the field and the specifics of what could constitute the first human vaccine developed for a chronic autoimmune disease. Expert commentary: Manufacturing of a clinical CVB vaccine as well as preclinical studies are currently in progress in order to enable clinical testing of the first CVB vaccine. Ongoing scientific research projects can significantly facilitate this effort by providing insights into the mechanisms of the CVB-T1D association.

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Live attenuated enterovirus vaccine (OPV) is not associated with islet autoimmunity in children with genetic susceptibility to type 1 diabetes: prospective cohort study

Cited by 5 publications

References 29 publications

Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort

Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort

Burden and etiology of moderate and severe diarrhea in children less than 5 years of age living in north and south of China: Prospective, population-based surveillance

Developing a vaccine for type 1 diabetes by targeting coxsackievirus B

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