Investigation of enterovirus infections, autoimmune factors and HLA genotypes in patients with T1DM

Minerva Endocrinol. 2014 Mar;39(1):67-74.


Aim: Besides of genetic and autoimmun factors, role of viral infections have been investigated in pathogenesis of type 1 diabetes mellitus (T1DM). The aim of this study was to determine enterovirus (EV) infections, glutamic acid decarboxylase (GAD) antibody positivity and HLA genotype distribution in T1DM patients with respect to corresponding healthy subjects. This is the first study in Turkey designed to investigate enteroviral infections and autoimmune and genetic factors together in this group of patients.

Methods: EV RNA, coxsackie virus B type 4 (CV-B4) antibodies, GAD antibodies and HLA genotypes were investigated in 86 patients with T1DM and in 100 control subjects.

Results: EV RNA was not detected in either the patient or control group. CV-B4 type antibodies and GAD antibodies were identified in 66.3% and 47.6% patients and 55.0% and 19% control subjects, respectively (for GAD antibodies P=0.001). High-risk HLA-DQ and high-risk HLA-DR genotypes for T1DM were identified in 67.3% and 86.0% of patients, respectively, and the difference was significantly higher compared with controls (34% and 40%, respectively, P=0.001).

Conclusion: There was no significant relation between CV-B4 neutralizing antibody, GAD antibody positivity and high-risk HLA genotypes in patients. In conclusion, no correlation was found in this study between T1DM and EV infections. In addition, there was no relation between EV infections and T1DM in patients with high-risk genotypes or in patients with autoimmunity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibodies, Viral / immunology
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Autoimmune Diseases / epidemiology
  • Autoimmune Diseases / etiology*
  • Autoimmune Diseases / immunology
  • Case-Control Studies
  • Child
  • Coxsackievirus Infections / complications
  • Coxsackievirus Infections / epidemiology
  • Coxsackievirus Infections / immunology
  • Coxsackievirus Infections / virology
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / etiology*
  • Diabetes Mellitus, Type 1 / immunology
  • Disease Susceptibility
  • Enterovirus B, Human / isolation & purification
  • Enterovirus Infections / complications*
  • Enterovirus Infections / epidemiology
  • Enterovirus Infections / immunology
  • Enterovirus Infections / virology
  • Female
  • Genetic Predisposition to Disease
  • Genotype
  • Glutamate Decarboxylase / immunology*
  • HLA Antigens / genetics*
  • Humans
  • Male
  • Molecular Mimicry
  • RNA, Viral / blood
  • Turkey / epidemiology
  • Viral Nonstructural Proteins / immunology


  • Antibodies, Viral
  • Autoantibodies
  • HLA Antigens
  • RNA, Viral
  • Viral Nonstructural Proteins
  • Glutamate Decarboxylase