Enteroviruses as causative agents in type 1 diabetes: loose ends or lost cause?

Trends Endocrinol Metab. 2014 Dec;25(12):611-9. doi: 10.1016/j.tem.2014.08.002. Epub 2014 Aug 28.


Considerable evidence implies that an enteroviral infection may accelerate or precipitate type 1 diabetes (T1D) in some individuals. However, causality is not proven. We present and critically assess evidence suggesting that islet β cells can become infected with enterovirus, and argue that this may result in one of several consequences. Occasionally, a fully lytic infection may arise and this culminates in fulminant diabetes. Alternatively, an atypical persistent infection develops which can be either benign or promote islet autoimmunity. We propose a model in which the 'strength' of the β cell response to the establishment of a persistent enteroviral infection determines the final disease outcome.

Keywords: Coxsackievirus; islets of Langerhans; pathogen recognition receptors; persistent infection; type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 1 / pathology*
  • Diabetes Mellitus, Type 1 / virology*
  • Enterovirus / pathogenicity*
  • Humans
  • Insulin-Secreting Cells / pathology
  • Insulin-Secreting Cells / virology
  • Islets of Langerhans / cytology