[Virus and insulin-dependent diabetes mellitus. Etiopathogenic perspectives]

Epidemiologic studies suggest an association between insulin dependent diabetes mellitus and viral infections. Several candidates like cytomegalovirus, Coxsackie virus and hepatitis virus have a selective tropism for beta cells. Progress in the understanding of the pathogenic importance of such viruses has been facilitated by animal models with virus induced diabetes and infections of human pancreatic beta cells maintained in culture. Immunological studies of type I diabetes after viral infections suggest that virus may trigger pancreatic autoimmunity. Molecular mimicry between viral and tissue antigens may represent a possible mechanism. Loss of immune tolerance toward beta cells would only appear in genetically predisposed individuals. The better understanding of the pathogenesis of type I diabetes mellitus brings out new approaches to treatment.