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.
BACKGROUND
The penetrance of type 1 diabetes mellitus (T1DM) in a genetically susceptible population is largely determined by environmental influences amongst which the human enteroviruses are prominent putative factors.


OBJECTIVE
The aim of this study was to determine the occurrence of enterovirus RNA in serum of children with type 1 diabetes at onset and ICA-positive subjects in a population with low incidence of type 1 diabetes and high circulation of enteroviruses.


METHODS
Serum samples were collected from children with newly diagnosed type 1 diabetes (n = 34); islet autoantibody-positive (n = 32) and -negative (n = 31) first-degree relatives of type 1 diabetic patients; and control subjects (n = 194). Enteroviral RNA was assessed using a highly sensitive reverse transcriptase-polymerase chain reaction method.


RESULTS
The frequency of positive signals corresponding to enteroviral sequence amplifications were higher in newly diagnosed T1DM children (9/34, 26.5%) and islet autoantibody-positive first-degree relatives (5/32, 15.6%) than in their corresponding matched controls (2/68, 2.9%, p = 0.0007 and 0/64, 0.0%, p = 0.0033, respectively). The presence of enteroviral RNA appeared to be associated with severe diabetic ketoacidosis at onset (pH < 7.1, p = 0.0328) and high ICA titres ( > or = 20 JDF units, p < 0.05).


CONCLUSIONS
Despite there is a high circulation of enteroviruses and a low type 1 diabetes incidence in the Cuban population, the presence of enteroviral RNA is associated with type 1 diabetes and beta-cell autoimmunity and is similar to European countries in which this scenario is reversed.
Sarmiento
Luis
L
Department of Virology, Pedro Kouri Tropical Medicine Institute, Havana, Cuba. diabetes@infomed.sld.cu
Cabrera-Rode
Eduardo
E
Lekuleni
Lister
L
Cuba
Ileana
I
Molina
Gisela
G
Fonseca
Magile
M
Heng-Hung
Lai
L
Borroto
Abel Diaz
AD
Gonzalez
Pedro
P
Mas-Lago
Pedro
P
Diaz-Horta
Oscar
O
D000293:Adolescent; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003462:Cuba; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D004770:Enterovirus; D004769:Enterovirus Infections / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D005060:Europe; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D050417:Insulin-Secreting Cells / Q000276:immunology; D008297:Male; D012367:RNA, Viral / Q000097:blood*
D001323:Autoantibodies; D012367:RNA, Viral