Type 1 diabetes associated genes account for less than 50% of disease susceptibility. Human enteroviruses have been implicated as environmental factors that might trigger and/or accelerate this autoimmune disorder. We now report of a 12-year-old girl that developed pancreatic autoimmunity and type 1 diabetes after enteroviral infection. Diabetes-associated autoimmunity was evaluated by measurement of several islet cell related autoantibodies. Neutralizing antibodies to different enteroviruses were determined in the case and eight children suffering from aseptic meningitis during a large scale epidemic. Several types of diabetes-associated antibodies were detected post-infection in the adolescent with newly diagnosed type 1 diabetes, including islet cell antibodies (ICA) and tyrosine phosphatase antibodies (IA2A). ICA but not IA2A appeared in the non-diabetic enterovirus-infected subjects. Based on virological studies, type 1 diabetes pathogenesis process could have been triggered by echovirus 30 infections. This study provides the first evidence of an association between echovirus 30 infection with the presence of pancreatic autoimmunity and type 1 diabetes. Our data suggest that echovirus 30 Cuban strain could be considered a potentially diabetogenic enteroviral variant.
These data show that exclusion of glibenclamide in the treatment of ICA+ type 2 diabetic patients partially decreases specific autoimmunity against endocrine pancreatic cells and improves metabolic control. This may reflect decreased expression of B-cell autoantigens suggesting that insulin monotherapy is a better choice for the treatment of LADA.
The human placenta synthesizes 1,25-dihydroxyvitamin D(3) and expresses the vitamin D receptor. Because preeclampsia (PE) is associated with low circulating levels of maternal 1,25-dihydroxyvitamin D(3) and IGF-I, it is possible that alterations in calcium metabolism seen in PE could occur at the level of the fetoplacental unit. In this study, the patterns of gene expression and enzyme activity of 25-hydroxyvitamin D-1 alpha-hydroxylase (1 alpha-hydroxylase) and the abundance of IGF-I mRNA in placentas from normal (NT) and PE-complicated pregnancies were investigated. Cultured syncytiotrophoblast cells from preeclamptic placentas had only one tenth the activity of 1 alpha-hydroxylase and did not respond to IGF-I, when compared with NT cultures. Similarly, the levels of 1 alpha-hydroxylase mRNA in syncytiotrophoblast cells from PE placentas under basal and IGF-I-stimulated conditions were significantly reduced. In contrast, IGF-I mRNA levels were found to increase during the differentiation process, with no differences between NT and PE cultures. These results support the role of placenta as a contributor to the abnormalities observed in calcium metabolism in PE.
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