Viruses as a potential environmental trigger of type 1 diabetes mellitus (Review)

Alves Abrantes,Jayra Juliana Paiva; Veríssimo de Azevedo,Jenner Chrystian; Fernandes,Fernando Liberalino; Almeida,Valéria Duarte; Custódio de Oliveira,Laura Andrade; Ferreira De Oliveira,Maryana Thalyta; Galvão de Araújo,Josélio Maria; Lanza,Daniel Carlos Ferreira; Bezerra,Fabiana Lima; Andrade,Vania Sousa; Araújo de Medeiros Fernandes,Thales Allyrio; Fernandes,José Veríssimo

doi:10.3892/br.2024.1770

Viruses as a potential environmental trigger of type 1 diabetes mellitus (Review)

Authors:
- Jayra Juliana Paiva Alves Abrantes
- Jenner Chrystian Veríssimo de Azevedo
- Fernando Liberalino Fernandes
- Valéria Duarte Almeida
- Laura Andrade Custódio de Oliveira
- Maryana Thalyta Ferreira De Oliveira
- Josélio Maria Galvão de Araújo
- Daniel Carlos Ferreira Lanza
- Fabiana Lima Bezerra
- Vania Sousa Andrade
- Thales Allyrio Araújo de Medeiros Fernandes
- José Veríssimo Fernandes
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Affiliations: Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte 59078‑970, Brazil, Department of Biomedical Sciences, Rio Grande do Norte State University, Mossoró, Rio Grande do Norte 59607‑360, Brazil, Laboratory of Applied Molecular Biology, Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte 59078‑970, Brazil
Published online on: March 26, 2024 https://doi.org/10.3892/br.2024.1770
Article Number: 81
Copyright: © Alves Abrantes et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The etiopathogenesis of type 1 diabetes mellitus (T1DM) is a complex multifactorial process that involves an intricate network of genetic, epigenetic, immunological, and environmental factors. Despite the advances in recent years, some aspects of the mechanisms involved in triggering the disease are still unclear. Infections with certain viruses have been suggested as possible environmental triggers for the autoimmune process that leads to selective and progressive destruction of pancreatic β‑cells and insufficiency of insulin production, which is its hallmark. In this review, advances in knowledge and evidence that suggest the participation of certain viruses in the mechanisms of disease initiation and progression are described. It has been accepted that environmental factors, including viruses, can initiate and possibly sustain, accelerate, or slow down the autoimmune process and consequently damage insulin‑producing pancreatic β‑cells. Although the role of these agents, especially human enteroviruses, has been exhaustively studied as the most likely triggers of the activation of autoimmunity that destroys pancreatic islets and leads to T1DM, certain doubts remain. Clinical epidemiological and experimental studies in humans and animals provide consistent and increasing evidence that persistent viral infections, especially with human enteroviruses and rotavirus infections, are associated with an increased risk of the disease in individuals genetically predisposed to autoimmunity.

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