Latest News! The "type 1 diabetes vaccine" has been developed, and "intestinal coxsackievirus infection" may be an important cause of the disease

Introduction: Type 1 diabetes mellitus is an endocrine metabolic disease caused by absolute deficiency of insulin due to severe destruction of islet β cells, which seriously endangers people's health, but the cause has not been fully explored
.

The latest research found that "intestinal coxsackievirus infection" may be an important factor in the onset of type 1 diabetes, and a "vaccine" against this mechanism has entered the clinical research stage
.

Coxsackievirus (Source: Photo China)

Type 1 diabetes: influenced by both genetics and environment

In the past 60 years, the incidence of type 1 diabetes worldwide has increased by 3%~5% per year, about 1 times
every 20 years.
The incidence of T1D in children is also increasing worldwide, with the fastest growing regions increasing by 10%
per year.

Genetic factors influence the onset and progression of the disease, but less than 50% of type 1 diabetes is due to genetics as an independent causative factor, indicating that environmental factors also play an important role
in the occurrence of the disease.
Numerous studies have shown that human enteroviruses, such as coxsackie group B virus infection, are strongly associated
with the occurrence of type 1 diabetes.

What is Coxsackievirus?

Coxsackievirus (Coxsackievirus) is an enterovirus (enterovirus), divided into A and B two categories, is a common type of respiratory and digestive tract infection of the human body, can cause a variety of diseases, including acute and chronic myocardial diseases, respiratory diseases, hand, foot and mouth syndrome, conjunctivitis, meningitis, etc.
, after infection people will appear fever, sneezing, cough and other cold symptoms
.

Coxsackievirus was first obtained in stool samples in 1948 by Dr.
Gillbert Dalldorf and his colleagues in their search for a cure for polio disease, and was named
after its discovery in the small town of Coxsackie in New York.
Like other types of enteroviruses, coxsackievirus can be transmitted
via the "fecal-oral route" and the "oral-oral route".

Coronavirus infection has been reported
to cause pancreatic damage leading to diabetes.
Experiments have shown that β cells cultured in vitro infected by coxsackie virus can cause β cell lysis and shrinkage death
.
In the coxsackievirus, CVB 4 type is most closely related to T1DM, and other strains such as CVB 5 do not seem to induce diabetes in mice, but after repeated passage, the genotype can be changed, and infected mice can also cause diabetes-like syndrome (chronic pancreatitis, blood glucose disorders, acinar tissue destruction and mild islet inflammation).

Important Environmental Factors in the Onset of T1D: New Evidence Refers to "Intestinal Coxsackievirus Infection"

The onset of type 1 diabetes is influenced by both genetic and environmental factors, and the latest research has found that "intestinal coxsackievirus infection" may be the "detonator" for the onset of type 1 diabetes!

Enterovirus infections and type 1 diabetes date back more than 50 years
.
A 1969 study drew attention to the association between new-onset diabetes and coxsackie-B enterovirus infection; In 2011, a foreign research team published a retrospective study to draw people's attention to enterovirus infection and type 1 diabetes, and the latest academic results presented at the annual meeting of the European Association for the Study of Diabetes in 2022 are pointing to "intestinal coxsackievirus infection" as an important cause of
type 1 diabetes.

The systematic analysis included data from 60 studies covering approximately 12,000 participants, and an analysis of data on new-onset diabetes found:

➤ Within the first month of diagnosis of type 1 diabetes, patients are 16 times more likely to develop enterovirus infections than the general population;

➤ This association is stronger in people with a genetic predisposition to type 1 diabetes or a first-degree relative of the disease (29 times more likely to be enterovirus infected);

An in-depth analysis of virus types found that coxsackie-B virus infection was most strongly
associated with type 1 diabetes.

The "leaky gut" hypothesis

The researchers note that the number, timing, duration and even site of infection of enterovirus infections may also be important
.
The "gut leak" hypothesis suggests that viruses originating in the gut can spread to the pancreas along with activated immune cells, and that low levels of persistent infection and the resulting inflammation can lead to an autoimmune response that induces type 1 diabetes
.

But this does not mean that enteroviral infections are the only cause of
type 1 diabetes.
The virus that causes diabetes seems to require the involvement of other factors, such as diet, imbalance of the gut microbiota, chemical exposure in the uterus (during pregnancy) or early
childhood.
But there is no doubt that these findings provide further support
for the development of vaccines to prevent the development of islet autoimmune diseases and reduce the incidence of T1D.
”

A "vaccine for type 1 diabetes" is under development

Type 1 diabetes is a highly heterogeneous disease, and if it is confirmed that an enterovirus infection plays a key role in certain populations, preventing such viral infections may significantly reduce the incidence
of new cases.

A team of researchers in Europe has developed a vaccine against coxsackie-B enterovirus, which is currently undergoing clinical trials to reduce the risk of type 1 diabetes in high-risk
children.

Resources:

[1] Rich Haridy.
Increasing evidence a common virus triggers type 1 diabetes.
2022-10-2.
https://newatlas.
com/health-wellbeing/ enterovirus-evidence-common-virus-triggers-type-1-diabetes/

[2] K.
-P.
Knoch,A.
Kosok,Z.
Marinicova,et al.
Coxsackie virus protease 2A alters the sorting of insulin secretory granule cargoes and induces the premature activation of cathepsins.
https://link.
springer.
com/article/10.
1007/ s00125-022-05755-w

[3]https://clinicaltrials.
gov/ct2/show/NCT04690426

[4] Chen Sisi, Zheng Yu.
Research progress on the relationship between coxsackievirus and the pathogenesis of type 1 diabetes.
International Journal of Pediatrics.
2011,38(3): 310-312,Seal 3.
DOI: 10.
3760/cma.
j.
issn.
1673-4408.
2011.
03.
033.

[5] SUN Chunrong, CUI Xiaodai.
Research progress on the relationship between coxsackievirus and the pathogenesis of type 1 diabetes.
International Journal of Pediatrics.
2006,33(3): 159-161.
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