SEVERAL DIFFERENT ENTEROVIRUS SEROTYPES CAN BE ASSOCIATED WITH PREDIABETIC AUTOIMMUNE EPISODES AND ONSET OF OVERT IDDM

In a prospective multicentre study described previously on prediabetic events in siblings of index cases with insulin-dependent diabetes mel litus, 31 children developed clinical diabetes during the observation period and 51 children seroconverted for islet cell antibodies or insu lin autoantibodies. By using nonserotype specific EIA and RIA, it has shown recently that enterovirus infections in both groups were frequen tly associated with increases of islet cell antibody and/or insulin au toantibody titres. Serum specimens sequentially collected from 12 chil dren during the prediabetic period were still available and were then tested for serotype-specific neutralizing antibodies. Plaque-neutraliz ation assays were carried out for coxsackievirus A9, coxsackievirus B types 1 to 6, and echovirus types 1 and 11. An unequivocal monotypic i ncrease in neutralizing antibodies was observed on seven occasions in six children, on one occasion with coxsackievirus A9, one with coxsack ievirus B1, two with coxsackievirus B2, two with coxsackievirus B3, an d one with coxsackievirus B5. In four patients, the infection was asso ciated temporally with increases in the levels of islet cell antibodie s, insulin autoantibodies and/or antibodies to glutamic acid decarboxy lase, and in three other patients, it coincided with the clinical onse t of insulin-dependent diabetes mellitus. These results suggest that t he association of enterovirus infections with insulin-dependent diabet es mellitus is not restricted to serotype 4 of coxsackie B viruses sus pected previously, but that several different serotypes might play a r ole in the pathogenesis of the disease. J. Med. Virol. 56:74-78, 1998. (C) 1998 Wiley-Liss, Inc.