Indications that maternal coxsackie B virus infection during pregnancy is a risk factor for childhood-onset IDDM.
In a population-based setting, we traced serum samples collected at time of birth from 55 mothers whose children later developed insulin-dependent diabetes (IDDM) and matched them pairwise to control subjects who gave birth at the same hospital during the same month. The sera were analysed for IgM antibodies to coxsackie B virus serotypes 2, 3 and 4 (CBV-2, 3 and 4) using a type-specific mu-antibody-capture radioimmunoassay. Despite a decreased power due to the close matching by time of birth we found a significantly higher frequency of CBV-3 IgM at delivery in mothers whose children later became diabetic compared to their matched control subjects. When using the presence of CBV-3 IgM as a risk factor the Mantel-Haenszel odds ratio estimate (95% confidence limits) was 2.57 (1.02; 7.31), p = 0.043. For CBV-2 and CBV-4, respectively no significant difference was found between mothers of patients and control subjects. According to the odds ratio estimate for CBV-3 and the proportion of exposed mothers among patients estimated in this study the aetiological fraction for this risk determinant would be 27%. In conclusion, this study indicates that children of mothers who expressed CBV IgM at delivery are at increased risk for developing childhood onset IDDM. A fetal infection with CBV similar to rubella virus may initiate autoimmunity or cause persistent infection that may lead to progressive beta-cell destruction.
Dahlquist
G
G
Department of Pediatrics, Umeå University, Sweden.
Frisk
G
G
Ivarsson
S A
SA
Svanberg
L
L
Forsgren
M
M
Diderholm
H
H
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003384:Coxsackievirus Infections / Q000150:complications* / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology*; D029822:Enterovirus B, Human / Q000276:immunology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007223:Infant; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis; D012307:Risk Factors
D000907:Antibodies, Bacterial; D007075:Immunoglobulin M