May 24, 2002.
By John von Radowitz,
Scientists have found a strong clue that childhood diabetes is linked to a common virus, it was disclosed today.
British researchers discovered a marked difference in the way healthy individuals and newly diagnosed diabetics reacted to a virus called coxsackie B4.
If confirmed, it may mean that a vaccine could be developed to prevent the illness. Type 1 diabetes is an autoimmune disease which deprives the body of insulin, the essential hormone that controls blood sugar levels.
It usually begins in childhood, and affects as many as one in 200 people. If unmanaged, it can lead to blindness, kidney failure and heart disease.
Why the disease occurs has never been clear, but scientists suspect that a complex interaction between genes and environmental factors is involved.
The new study, backed by the charity Action Research, suggests that an over-active immune response to the coxsackie B4 virus (CVB4) may trigger diabetes.
The virus might cause the immune system to go into overdrive and start attacking and killing the cells in the pancreas that produce insulin.
CVB4 causes typical 'flu-like symptoms, and most commonly affects children.
Several years ago a strain of the virus was recovered from the pancreas of a child dying from Type 1 diabetes.
Using the virus's genetic code, the researchers were able to reproduce key parts of its structure and see how they affected the immune system.
Tests of blood samples taken from about 40 teenage and young adult Type 1 diabetics showed that the immune system was very sensitive to CVB4.
The response was different between diabetics and healthy individuals in a way that suggested recent or repeated exposure to the virus.
Dr Mark Peakman, from the Department of Immunology at Guy's, King's and St Thomas' School of Medicine, who led the study, said: "A virus is like an enemy invasion that the body fights with using an 'infantry' of anti-viral cells called effector cells, that counteract the virus.
"At the same time the body also keeps in reserve 'troops' of memory cells that can quickly turn into effector cells the next time the virus is encountered.
"Our research found that there were significantly more effector cells among the diabetics than the healthy patients.
"If the virus had nothing to do with the disease we would expect to find the same distribution of effector cells in healthy individuals and those with diabetes.
"But there were far more of these in the diabetics, suggesting they'd had a close and recent encounter with the CVB4 virus.
"The implications are clear. If viruses have a proven role in the disease, there is the future possibility of developing vaccines to prevent infection and therefore Type 1 diabetes."
The findings are published in the American journal Diabetes.
Diabetes currently affects 1.4 million diagnosed people, but an estimated one million people have the disease without knowing it.
Incidence of the disease - 10% of the NHS budget is spent on treating it - is on the increase.
Sir George Alberti, president of the International Diabetes Federation, has called it the "Aids epidemic of the 21st Century".
Dr Peakman said research into diabetes was "unbelievably" important if a future epidemic was to be avoided.
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