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IgM against Coxsackie B viruses in children developing type I diabetes mellitus--a seven-year retrospective study
Insights
Coxsackievirus B (CB) IgM antibodies were found in children with new-onset insulin-dependent diabetes mellitus (IDDM). These findings suggest CB virus infection may be linked to IDDM in less than half of pediatric cases, with seasonal patterns observed.
Area of Science:
- Virology
- Immunology
- Pediatric Endocrinology
Background:
- Recent observations suggest a link between IgM antibodies to coxsackievirus B types 1-5 (CB 1-5) and newly diagnosed insulin-dependent diabetes mellitus (IDDM) in children.
- Previous studies indicated a potential association, prompting further investigation into the role of CB virus in IDDM pathogenesis.
Purpose of the Study:
- To investigate the prevalence of CB-IgM antibodies in children with newly diagnosed IDDM in two Swedish counties.
- To explore potential correlations between CB-IgM positivity, IDDM incidence, seasonality, and specific coxsackievirus serotypes.
Main Methods:
- A cohort of pediatric IDDM patients diagnosed between 1978-1984 in Uppsala and Linköping, Sweden, were studied.
- CB-IgM antibodies were quantified using a mu-antibody capture radioimmunoassay (RIA).
- IDDM incidence rates and seasonal onset patterns were analyzed in relation to CB-IgM findings.
Main Results:
- IDDM incidence varied between 11.1 and 40.8 per 100,000 children.
- CB-IgM antibodies were detected in 40% of Uppsala patients and 30% of Linköping patients.
- IDDM onset peaked in January, August, and October, coinciding with higher CB-IgM positivity; serotype prevalence shifted over the study period.
Conclusions:
- Coxsackievirus B infection may contribute to IDDM pathogenesis in a subset of pediatric patients.
- The findings suggest a complex relationship influenced by seasonal variations and evolving coxsackievirus serotype epidemiology.
- While not universally present, CB-IgM positivity indicates a potential viral trigger for IDDM in some children.
Abstract:
IgM antibodies to coxsackievirus type B 1-5 (CB 1-5) have recently been observed in sera from children with newly diagnosed insulin-dependent diabetes mellitus (IDDM). In the present study IDDM patients below 15 years of age diagnosed between 1978 and 1984 inclusive in two different areas (counties) of Sweden, Uppsala and Linköping, were studied at the onset of their disease. The incidence of IDDM per 100,000 children below the age of 15 years varied between 11.1 and 40.8, with a mean of 26.3 in Uppsala and 23.0 in Linköping. CB-IgM was determined by a mu-antibody capture radioimmunoassay (RIA) and was found in the sera of 40% (range 15-76%) of the Uppsala patients and 30% (0-57%) of the Linköping patients. The IDDM onset peaked in January, August and October, and these months also displayed the largest numbers of CB-IgM-positive cases. There seemed to be a relation between IDDM incidence and CB-IgM positivity, but not during the whole period. IgM antibodies against CB2 and CB3 predominated during the first part of the study period, whereas during the last two years IgM antibodies against all five serotypes were demonstrated. It is concluded that if CB virus infection is involved in the pathogenesis of IDDM in children, this may be the case in less than half of the patients, though with seasonal and annual peaks and nadirs and also changes of serotypes that may reflect the natural epidemiology of these viruses.