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Can childhood viral infection protect from type 1 diabetes?
Terry B. Strom
Terry B. Strom
Published May 26, 2009
Citation Information: J Clin Invest. 2009;119(6):1458-1461. https://doi.org/10.1172/JCI39565.
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Commentary

Can childhood viral infection protect from type 1 diabetes?

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Abstract

While many candidate type 1 diabetes (T1D) susceptibility genes have been identified, evidence suggests that environmental stimuli, such as viral infections, may also be involved in T1D pathogenesis. However, how viral infections may prevent or trigger the diabetogenic process remains unclear. In this issue of the JCI, Filippi et al. show that infection of NOD mice with Coxsackie virus B3 or lymphocytic choriomeningitis virus, neither of which directly destroys insulin-secreting pancreatic β cells, triggers the activation of two distinct immunoregulatory mechanisms, involving both the innate and adaptive immune system, that protect against the development of T1D in these animals (see the related article beginning on page 1515).

Authors

Terry B. Strom

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Figure 1

Immunoregulatory mechanisms induced by viral infection protect against T1D in mice.

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Immunoregulatory mechanisms induced by viral infection protect against T...
In their study in this issue of the JCI, Filippi et al. examined the mechanisms by which infection with CVB3 or LCMV (which do not directly destroy insulin-producing pancreatic β cells) reduced the incidence and delayed the onset of T1D in NOD mice (2). The authors report that immune cells from both the innate and adaptive immune system are involved in curbing the expansion of autoaggressive T cells that target β cells. They show that IFN-γ produced by adaptive Th1 cells, as well as by various innate immune cells in response to viral infection, upregulates the expression of PD-L1 on a varied population of lymphoid cells. Following interaction with β cell antigen IGRP, activated autoaggressive T cells express the PD-L1 receptor PD-1. PD-1+ T cells and PD-L1+ cells occupy overlapping habitats. The cognate interaction of PD-1 with PD-L1 inhibits the expansion of IGRP-specific, diabetogenic PD-1+ CD8+ T cells, which delays the onset of T1D. CD4+CD25+ Tregs, which are part of the adaptive immune system, are activated by both viruses and autoantigens. These cells produce TGF-β, a potent immunosuppressive cytokine. Filippi et al. also show that after CVB3 or LCMV infection in NOD mice, the populations of Tregs in the pancreatic lymph node and spleen were increased. Production of TGF-β by these cells curbed the expansion of autoaggressive T cells and limited their cytodestructive properties, thereby protecting insulin-producing β cells and reducing the incidence of T1D in these animals. The physical proximity of regulatory and cytodestructive autoimmune cells enables immunoregulation.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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