MD Conference Express EASD 2012 - (Page 24)

n sElEcTEd UpdATEs in diAbETEs And EnTEROviRUs Diabetes and Enterovirus Infection: The Evidence and Implications Written by Rita Buckley With evidence accumulating that the β-cells of patients with type 1 diabetes (T1DM) can be infected with enterovirus [Richardson SJ et al. Diabetologia 2009], the question if enterovirus could cause β-cell damage and T1DM has become increasingly relevant [Tauriainen S et al. Semin Immunopathol 2011]. Noel G. Morgan, PhD, University of Exeter, Exeter, United Kingdom, discussed the evidence of viral infection in the pancreas of patients with T1DM. A systematic review and meta-analysis recently found a clinically significant association between enterovirus infection detected with molecular methods and autoimmunity/T1DM [Yeung WC et al. BMJ 2011]. While observational studies cannot assign causation, the results provide additional support to direct evidence of enterovirus infection in pancreatic tissues of individuals with T1DM [Dotta F et al. Proc Natl Acad Sci USA 2007]. Willcox et al. [Diabetologia 2010] found that α-and β-cells undergo a marked increase in proliferation during the progression of T1DM in humans (Figure 1). These results imply that islet cell proliferation is re-initiated in response to the autoimmune attack associated with T1DM. Figure 1. Islet Cell Proliferation Is Increased in Response to Insulitis. 15 Mean % Ki67+ islets/section 10 5 0 nt ro ls Co Peer-Reviewed Highlights of Patient Group Control: 4031 islet sections Type 1 diabetes: 1280 islet sections Reprinted from Willcox A et al. Evidence of increased islet cell proliferation in patients with recent-onset type 1 diabetes. Diabetologia 2010;3(9):2020-2028, with permission from Springer Verlag. In 2007, Dotta et al. [Proc Natl Acad Sci USA 2007] found direct evidence that the enterovirus can infect β-cells in patients with T1DM, and infection is associated with inflammation and functional impairment. Two years later, Richardson et al. [Diabetologia 2009] demonstrated that the immunoreactive enteroviral capsid protein vp1 is commonly found in the islets of recent-onset diabetes patients but only rarely in normal pediatric controls. A strong correlation was also seen between islet cell vp1 positivity and protein kinase R (PKR) production in insulin-containing islets of type 1 and type 2 diabetic patients. 24 Ty pe 1 di ab et es November 2012 www.mdconferencexpress.com  http://www.mdconferencexpress.com

Table of Contents for the Digital Edition of MD Conference Express EASD 2012

MD Conference Express EASD 2012
Contents
Understanding Incretin Hormone Action and the Treatment of Diabetes
New ADA/EASD Guidelines Focus on Patient-Centered Care
ORIGIN Trial: Insulin Glargine and n-3 Fatty Acids Fail to Reduce CV Events in Diabetic Patients
Exenatide Once Weekly Sustained Improvement in Glycemic Control with Weight Loss Through 4 Years
DiaPep277® Shows Promise as a Therapeutic Strategy for T1DM
Linagliptin Proves Safe and Effective as Add-on Therapy to Basal Insulin
12-Week Treatment with LY2409021 Significantly Lowers HbA1C and Is Well Tolerated in Patients with T2DM
Insulin Degludec Is Superior to Sitagliptin in Improving Glycemic Control in Uncontrolled Patients with Type 2 Diabetes on Oral Agents
Dapagliflozin Does Not Impact Renal Function in Patients with T2DM
Population-Based Screening for T2DM:The ADDITION-Cambridge Trial
The Challenges of Pharmaceutical Management of Painful Diabetic Peripheral Neuropathy
Enterovirus Infection
Novel Oral Agents
GLP-1
Genetics
Renal Denervation
Hypertension and Renal Function Are Risk Factors for CAD in T1DM

MD Conference Express EASD 2012

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