Coxsackieviruses and Insulitis

Coxsackievirus infections are believed to be a relevant risk factor in the induction of pancreatic beta cell damage and autoimmune response in type 1 diabetes mellitus. Genomic RNA and proteins of coxsackieviruses have been detected in tissues of type 1 diabetes patients, supporting the involvement of enteroviruses in the pathogenesis of type 1 diabetes. Coxsackieviruses may infect beta cells, trigger the activation of innate immune systems, or accelerate the autoimmune process leading to the disease. Local inflammatory changes generated in pancreatic islets and the mechanisms leading to its generation and progression have been studied in animal models of type 1 diabetes and in humans. The role of coxsackieviruses in the insulitic process is discussed in this chapter, together with the ability of selected coxsackievirus serotypes to protect against type 1 diabetes.