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Enterovirus Immunity and the “Hygiene Hypothesis”

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Diabetes and Viruses

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Abstract

The current knowledge fits with a scenario where one or more commonly circulating enteroviruses initiate the beta-cell damaging process in early childhood. These viruses may represent certain enterovirus types and strains which have special properties explaining their ability to cause beta-cell damage (e.g., tropism to islet cells). Particular susceptibility for the virus is probably needed and only a small fraction of infected individuals may develop beta-cell damage. In this sense type 1 diabetes has many similarities with polio, the well-known enterovirus disease. Based on experience from polio, both the increasing incidence of type 1 diabetes and the remarkable geographical variation in the incidence rates can be related to varying circulation of diabetogenic enteroviruses in these populations. On the hand, animal experiments have suggested that under certain conditions enteroviruses may also have a protective effect, which seem to be mediated by their ability to activate immunoregulatory mechanisms. Both these aspects (risk vs. protective effect) should be taken into account when possible viral effects on the epidemiology of type 1 diabetes are investigated. Large-scale birth cohort studies, such as the TEDDY study, will play a key role in the identification of these effects and virus–host interactions which determine the outcome of the infection.

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Acknowledgments

I wish to thank Hanna Viskari, M.D., Ph.D., Maria Lönnrot, M.D., Ph.D., Anita Kondrashova, M.D., Ph.D., Sisko Tauriainen, Ph.D., Sami Oikarinen, M.Sc. and all other collaborators contributing to the findings summarized in this chapter. The studies summarized in this chapter have been financially supported by the Juvenile Diabetes Research Foundation, European Commission, Sohlberg’s Foundation, and the Academy of Finland.

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  1. Department of Virology, University of Tampere and Tampere University Hospital, Biokatu 10, 33520, Tampere, Finland

    Heikki Hyöty M.D., Ph.D.

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  1. Heikki Hyöty M.D., Ph.D.
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Correspondence to Heikki Hyöty M.D., Ph.D. .

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Editors and Affiliations

  1. Queen Mary's School of Medicine and Dent, Centre for Diabetes & Metabolic Medicine, Institute of Cell & Molecular Science, n/a, London, E1 2AT, United Kingdom

    Keith Taylor

  2. Tampere University Hospital, Department of Virology, University of Tampere, n/a, Tampere, 33520, Finland

    Heikki Hyöty

  3. University of Insubria & Ospedale di Cir, Varese, Italy

    Antonio Toniolo

  4. University College London Medical School, n/a, London, NW3 2PF, United Kingdom

    Arie J. Zuckerman

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Hyöty, H. (2013). Enterovirus Immunity and the “Hygiene Hypothesis”. In: Taylor, K., Hyöty, H., Toniolo, A., Zuckerman, A. (eds) Diabetes and Viruses. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4051-2_14

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