The prevalence of enteroviral capsid protein vp1 immunostaining in pancreatic islets in human type 1 diabetes

Springer Science and Business Media LLC - Tập 52 - Trang 1143-1151 - 2009
S. J. Richardson1, A. Willcox1, A. J. Bone2, A. K. Foulis3, N. G. Morgan1
1Institute of Biomedical and Clinical Sciences, Peninsula Medical School, Plymouth, UK
2School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
3Department of Pathology, Royal Infirmary, Glasgow,UK

Tóm tắt

Evidence that the beta cells of human patients with type 1 diabetes can be infected with enterovirus is accumulating, but it remains unclear whether such infections occur at high frequency and are important in the disease process. We have now assessed the prevalence of enteroviral capsid protein vp1 (vp1) staining in a large cohort of autopsy pancreases of recent-onset type 1 diabetic patients and a range of controls. Serial sections of paraffin-embedded pancreatic autopsy samples from 72 recent-onset type 1 diabetes patients and up to 161 controls were immunostained for insulin, glucagon, vp1, double-stranded RNA activated protein kinase R (PKR) and MHC class I. vp1-immunopositive cells were detected in multiple islets of 44 out of 72 young recent-onset type 1 diabetic patients, compared with a total of only three islets in three out of 50 neonatal and paediatric normal controls. vp1 staining was restricted to insulin-containing beta cells. Among the control pancreases, vp1 immunopositivity was also observed in some islets from ten out of 25 type 2 diabetic patients. A strong correlation was established between islet cell vp1 positivity and PKR production in insulin-containing islets of both type 1 and type 2 diabetic patients, consistent with a persistent viral infection of the islets. Immunoreactive vp1 is commonly found in the islets of recent-onset type 1 diabetes patients, but only rarely in normal paediatric controls. vp1 immunostaining was also observed in some islets of type 2 diabetes patients, suggesting that the phenomenon is not restricted to type 1 diabetes patients.

Tài liệu tham khảo

Gale EAM (2008) Congenital rubella: citation virus or viral cause of type 1 diabetes? Diabetologia 51:1559–1566 Gamble DR, Kinsley ML, FitzGerald MG, Bolton R, Taylor KW (1969) Viral antibodies in diabetes mellitus. BMJ 3:627–630 Andreoletti L, Hober D, Hober-Vandenberghe C et al (1997) Detection of Coxsackie B virus RNA sequences in whole blood samples from adult patients at the onset of type I diabetes mellitus. J Med Virol 52:121–127 Clements GB, Galbraith DN, Taylor KW (1995) Coxsackie B virus infection and onset of childhood diabetes. Lancet 346:221–223 Coutant R, Carel JC, Lebon P, Bougneres PF, Palmer P, Cantero-Aguilar L (2002) Detection of enterovirus RNA sequences in serum samples from autoantibody-positive subjects at risk for diabetes. Diabet Med 19:968–969 Elfaitouri A, Berg AK, Frisk G, Yin H, Tuvemo T, Blomberg J (2007) Recent enterovirus infection in type 1 diabetes: evidence with a novel IgM method. J Med Virol 79:1861–1867 Moya-Suri V, Schlosser M, Zimmermann K, Rjasanowski I, Gurtler L, Mentel R (2005) Enterovirus RNA sequences in sera of schoolchildren in the general population and their association with type 1-diabetes-associated autoantibodies. J Med Microbiol 54:879–883 Nairn C, Galbraith DN, Taylor KW, Clements GB (1999) Enterovirus variants in the serum of children at the onset of Type 1 diabetes mellitus. Diabet Med 16:509–513 von Herrath M (2009) Can we learn from viruses how to prevent type 1 diabetes? The role of virus infections in the pathogenesis of type 1 diabetes and the development of novel combination therapies. Diabetes 58:2–11 Sarmiento L, Cabrera-Rode E, Lekuleni L et al (2007) Occurrence of enterovirus RNA in serum of children with newly diagnosed type 1 diabetes and islet cell autoantibody-positive subjects in a population with a low incidence of type 1 diabetes. Autoimmunity 40:540–545 Yoon JW, Austin M, Onodera T, Notkins AL (1979) Isolation of a virus from the pancreas of a child with diabetic ketoacidosis. N Engl J Med 300:1173–1179 Ylipaasto P, Klingel K, Lindberg AM et al (2004) Enterovirus infection in human pancreatic islet cells, islet tropism in vivo and receptor involvement in cultured islet beta cells. Diabetologia 47:225–239 Dotta F, Censini S, van Halteren AG et al (2007) Coxsackie B4 virus infection of beta cells and natural killer cell insulitis in recent-onset type 1 diabetic patients. Proc Natl Acad Sci U S A 104:5115–5120 Tam PE, Messner RP (1999) Molecular mechanisms of Coxsackie virus persistence in chronic inflammatory myopathy: viral RNA persists through formation of a double-stranded complex without associated genomic mutations or evolution. J Virol 73:10113–10121 Ylipaasto P, Kutlu B, Rasilainen S et al (2005) Global profiling of Coxsackie virus- and cytokine-induced gene expression in human pancreatic islets. Diabetologia 48:1510–1522 Chehadeh W, Kerr-Conte J, Pattou F et al (2000) Persistent infection of human pancreatic islets by Coxsackie virus B is associated with alpha-interferon synthesis by beta-cells. J Virol 74:10153–10164 Foulis AK, Farquharson MA, Meager A (1987) Immunoreactive alpha-interferon in insulin-secreting beta cells in type 1 diabetes mellitus. Lancet 2:1423–1427 Foulis AK, Liddle CN, Farquharson MA et al (1986) The histopathology of the pancreas in type 1 (insulin-dependent) diabetes mellitus: a 25-year review of deaths in patients under 20 years of age in the United Kingdom. Diabetologia 29:267–274 Oikarinen M, Tauriainen S, Honkanen T et al (2008) Analysis of pancreas tissue in a child positive for islet cell antibodies. Diabetologia 51:1796–1802 Oikarinen M, Tauriainen S, Honkanen T et al (2008) Detection of enteroviruses in the intestine of type 1 diabetic patients. Clin Exp Immunol 151:71–75 Andréoletti L, Bourlet T, Moukassa D et al (2000) Enteroviruses can persist with or without active viral replication in cardiac tissue of patients with end-stage ischemic or dilated cardiomyopathy. J Infect Dis 182:1222–1227 Triantafyllopoulou A, Tapinos N, Moutsopoulos HM (2004) Evidence for coxsackievirus infection in primary Sjögren's syndrome. Arthritis Rheum 50:2897–2902 Klingel K, Sauter M, Bock CT, Szalay G, Schnorr JJ, Kandolf R (2004) Molecular pathology of inflammatory cardiomyopathy. Medical Microbiol Immunol 193:101–107 Hilton DA, Day C, Pringle JH, Fletcher A, Chambers S (1992) Demonstration of the distribution of coxsackie virus RNA in neonatal mice by non-isotopic in situ hybridization. J Virol Methods 40:155–162 Härkönen T, Puolakkainen M, Sarvas M, Airaksinen U, Hovi T, Roivainen M (2000) Picornavirus proteins share antigenic determinants with heat shock proteins 60/65. J Med Virol 62:383–391 Härkönen T, Lankinen H, Davydova B, Hovi T, Roivainen M (2002) Enterovirus infection can induce immune responses that cross-react with beta-cell autoantigen tyrosine phosphatase IA-2/IAR. J Med Virol 66:340–350 Mallard K, Jones DB, Richmond J, McGill M, Foulis AK (1996) Expression of the human heat shock protein 60 in thyroid, pancreatic, hepatic and adrenal autoimmunity. J Autoimmun 9:89–96 Drescher KM, Tracy SM (2008) The CVB and etiology of type 1 diabetes. Curr Top Microbiol Immunol 323:259–274 Foulis AK, McGill M, Farquharson MA, Hilton DA (1997) A search for evidence of viral infection in pancreases of newly diagnosed patients with IDDM. Diabetologia 40:53–61 Everett H, McFadden G (1999) Apoptosis: an innate immune response to virus infection. Trends Microbiol 7:160–165 Foulis AK, Farquharson MA, Hardman R (1987) Aberrant expression of class II major histocompatibility complex molecules by B cells and hyperexpression of class I major histocompatibility complex molecules by insulin containing islets in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 30:333–343 Klingel KC, Hohenadl C, Canu A et al (1992) Ongoing enterovirus-induced myocarditis is associated with persistent heart muscle infection: quantitative analysis of virus replication, tissue damage and inflammation. Proc Natl Acad Sci U S A 89:314–318 Ehses JA, Perren A, Eppler E et al (2007) Increased number of islet-associated macrophages in type 2 diabetes. Diabetes 56:2356–2370 Witso E, Palacios G, Cinek O et al (2006) High prevalence of human enterovirus a infections in natural circulation of human enteroviruses. J Clin Microbiol 44:4095–4100 Cinek O, Witso E, Jeansson S et al (2006) Longitudinal observation of enterovirus and adenovirus in stool samples from Norwegian infants with the highest genetic risk of type 1 diabetes. J Clin Virol 35:33–40 Roivainen M (2006) Enteroviruses: new findings on the role of enteroviruses in type 1 diabetes. Int J Biochem Cell Biol 38:721–725 Roivainen M, Knip M, Hyoty H et al (1998) Several different enterovirus serotypes can be associated with prediabetic autoimmune episodes and onset of overt IDDM. Childhood Diabetes in Finland (DiMe) Study Group. J Med Virol 56:74–78