The Swedish childhood diabetes study III: IgM against coxsackie B viruses in newly diagnosed Type 1 (insulin-dependent) diabetic children ? no evidence of increased antibody frequency

Abstract

Summary. Sera from essentially all Swedish children aged 0-14 years with Type 1 (insulin-dependent) diabetes mellitus with onset during an autumn period (October-December 1985) and a late spring period (May-June 1986) were selected. In all, 98 patients were analysed for IgM antibodies against coxsackie B virus serotypes 1 through 5 by a Ix-antibody capture radio immunoassay technique. Sera from 94 referent children matched for age, sex and residential area, collected during the same period, were also analysed. During the autumn period, 10 out of 67 (15%) diabetic children were IgM positive while 14 out of 75 (19%) of the healthy referent children demonstrated positivity. During the late spring period only one out of 31 (3%) children with diabetes and two out of 19 (10%) referent children were IgM positive. In the diabetic patients, five were coxsackie B2 positive while coxsackie B1, 3, 4 and 5 were represented by one to three patients each. Eight referent children were coxsackie B4 positive, six were B3 positive and two B2 positive, while no referent children were positive against coxsackie B1 and 5. During these two periods in late 1985 and early 1986 these data demonstrate no evidence of increased antibody frequency against coxsackie B virus 1 through 5 at the onset of childhood diabetes in Sweden.

Enterovirus infections in young infants: Are children still protected by maternal antibodies?

“…4 Enterovirus infection(s) might be involved in the development of type 1 diabetes, 3,[5][6][7] even though some studies are contradicting. [8][9][10] Our previous epidemiological investigations clearly speak about the existence of inverse association between the prevalence of enterovirus infections and frequency of type 1 diabetes in background population. 11,12 Based on these findings we have launched "polio hypothesis" according to which the increase in type 1 diabetes incidence in some countries is due to a change in the epidemiology of enterovirus infections.…”

No association between islet cell antibodies and coxsackie B, mumps, rubella and cytomegalovirus antibodies in non-diabetic individuals aged 7?19 years

“…In previous studies no association between these virus infections and the onset of Type 1 diabetes was found [5][6][7]. Although mumps infection may result in transient ICA, islet cell surface antibodies and insulin-autoantibody responses [t9 -20], and may occasionally cause Type i diabetes [21], there is little evidence that these viruses are a significant cause of Type 1 diabetes.…”

“…Although the difference in prevalence between ICA positive and negative individuals was not statistically significant, a study of larger numbers would be required to exclude such an association. A number of serological studies have found a higher prevalence of coxsackie B virus-specific IgM responses in patients at Type 1 diabetes onset compared with control subjects [5,8,9,22] while others have not [6][7]. In one study, the prevalence of IgM among Type i diabetic patients showed considerable geographic and temporal variation, ranging from 0-76 % [9].…”

“…This evidence is based on studies in animal models [1], anecdotal case reports in which viruses have been isolated from patients at the time of Type 1 diabetes onset [2][3][4] and seroepidemiological studies to determine the prevalence of virus-specific IgM responses in patients with recently diagnosed Type 1 diabetes [5][6][7][8][9], indicating that virus infection is present in a proportion of patients around the time of diabetes onset. In view of the long incubation period before clinical diabetes becomes apparent in man, it is pertinent to consider whether virus infection may be involved in the initiation of the disease process, rather than simply the precipitation of disease in patients with already compromised Beta-cell function.…”

Could the aetiology of IDDM be multifactorial?

“…coxsackie viruses and/or a greater frequency of positive serotests for several enteroviruses when comparing cases and control subjects [5,6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Several of the 'negative' studies deserve comment.…”