Human enterovirus infections in children at increased risk for type 1 diabetes: the Babydiet study

• Published in: Diabetologia Vol. 54; no. 12; pp. 2995 - 3002
• Main Authors: Simonen-Tikka, M.-L., Pflueger, M., Klemola, P., Savolainen-Kopra, C., Smura, T., Hummel, S., Kaijalainen, S., Nuutila, K., Natri, O., Roivainen, M., Ziegler, A.-G.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-12-2011; Springer; Springer Nature B.V
• Subjects: Age; Antibodies; Antibodies, Viral - blood; Antibodies, Viral - immunology; Antigens; Autoantibodies; Autoantibodies - blood; Autoantibodies - immunology; Autoimmunity; Biological and medical sciences; Blood; Child; Child, Preschool; Children; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - immunology; Diabetes Mellitus, Type 1 - virology; Diabetes. Impaired glucose tolerance; Disease; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Enterovirus; Enterovirus - immunology; Enterovirus - isolation & purification; Enterovirus Infections - epidemiology; Enterovirus Infections - immunology; Enterovirus Infections - virology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feces; Feces - virology; Female; Gluten; Glutens - metabolism; Hepatitis E virus; Human Physiology; Humans; Incidence; Infant; Infection; Infections; Insulin; Internal Medicine; Intestine; Islets of Langerhans; Islets of Langerhans - immunology; Islets of Langerhans - virology; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Norovirus; Phosphatase; Pregnancy; Pregnancy in Diabetics - epidemiology; Prevalence; Risk Factors; Serotypes; Siblings; Viruses; Germany; Autoantibody; Islet autoimmunity; Human enterovirus; Stool; Type 1 diabetes; Intestinal viruses; Endocrinopathy; Human; Autoimmunity; Immunopathology; Digestive system; Picornaviridae; Gut; Autoimmune disease; Enterovirus; Virus; Infection; Risk factor; Child
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-011-2305-3

Aims/hypothesis
The aim of this study was to examine human enteroviruses (HEVs) and other intestinal viruses derived from children who participated in the Babydiet intervention study and to analyse the findings according to the appearance of islet autoantibodies, dietary intervention, maternal type 1 diabetes and clinical symptoms.
Methods
In the Babydiet study the influence of first gluten exposure (6 or 12 months) on the development of islet autoimmunity was investigated in 150 children with increased genetic and familial risk for type 1 diabetes. Blood and stool samples were collected at 3 monthly intervals until the age of 3 years and yearly thereafter. Infections and clinical symptoms were recorded daily for the first year. In the present study, 339 stool samples collected from 104 children during the first year of life were analysed for HEVs and a certain proportion of the samples were analysed for other intestinal viruses.
Results
HEV was detected in 32 (9.4%) samples from 24 (23.1%) children. Altogether 13 serotypes were identified, with HEV-A species being the most common. Children with gastrointestinal symptoms had norovirus (3/11) and sapovirus (1/11) infections in addition to HEV (1/11). Of the 104 children, 22 developed islet autoantibodies. HEV infections were detected in 18% (4/22) and 24% (20/82) of islet-autoantibody-positive and -negative children, respectively (
p
 = 0.5). The prevalence of HEV was similar in the gluten-exposed groups and in children from mothers with type 1 diabetes or from affected fathers and/or siblings (
p
 = 1.0 and 0.6, respectively).
Conclusions/interpretation
No correlation was found between the presence of HEV in the first year of life and the development of islet autoantibodies. There was no association between HEV infections and dietary intervention, maternal diabetes or clinical symptoms.