PT  - JOURNAL ARTICLE
AU  - Oikarinen, Maarit
AU  - Tauriainen, Sisko
AU  - Oikarinen, Sami
AU  - Honkanen, Teemu
AU  - Collin, Pekka
AU  - Rantala, Immo
AU  - Mäki, Markku
AU  - Kaukinen, Katri
AU  - Hyöty, Heikki
TI  - Type 1 Diabetes Is Associated With Enterovirus Infection in Gut Mucosa
AID  - 10.2337/db11-1157
DP  - 2012 Mar 01
TA  - Diabetes
PG  - 687--691
VI  - 61
IP  - 3
4099  - http://diabetes.diabetesjournals.org/content/61/3/687.short
4100  - http://diabetes.diabetesjournals.org/content/61/3/687.full
SO  - Diabetes2012 Mar 01; 61
AB  - Enterovirus infections have been linked to type 1 diabetes in several studies. Enteroviruses also have tropism to pancreatic islets and can cause β-cell damage in experimental models. Viral persistence has been suspected to be an important pathogenetic factor. This study evaluates whether gut mucosa is a reservoir for enterovirus persistence in type 1 diabetic patients. Small-bowel mucosal biopsy samples from 39 type 1 diabetic patients, 41 control subjects, and 40 celiac disease patients were analyzed for the presence of enterovirus using in situ hybridization (ISH), RT-PCR, and immunohistochemistry. The presence of virus was compared with inflammatory markers such as infiltrating T cells, HLA-DR expression, and transglutaminase 2–targeted IgA deposits. Enterovirus RNA was found in diabetic patients more frequently than in control subjects and was associated with a clear inflammation response in the gut mucosa. Viral RNA was often detected in the absence of viral protein, suggesting defective replication of the virus. Patients remained virus positive in follow-up samples taken after 12 months’ observation. The results suggest that a large proportion of type 1 diabetic patients have prolonged/persistent enterovirus infection associated with an inflammation process in gut mucosa. This finding opens new opportunities for studying the viral etiology of type 1 diabetes.