MicrobiologyBytes

In the last week there has been some fairly wild speculation in the media about viruses which “cause” diabetes. The fuss came from the publication of a paper which claimed to have detected virus proteins in the pancreases of diabetes patients (The prevalence of enteroviral capsid protein vp1 immunostaining in pancreatic islets in human type 1 diabetes. Diabetologia 6 March 2009). At the same time, a separate study found four rare mutations in a gene which is thought to reduce the risk of developing type 1 diabetes and may be involved in the immune response to infection with enteroviruses (Rare Variants of IFIH1, a Gene Implicated in Antiviral Responses, Protect Against Type 1 Diabetes. Science Mar 5 2009).

The press was buzzing with speculation about the chances of a vaccine to prevent diabates. Very good news for diabetics? Well not so fast. Before we look at the science, let me tell you two things about myself. First, I have two close relatives who are affected by diabetes, so this is a disease I care a lot about. Second, I’ve been in the virology business a long time – and we’ve been here before.

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The new paper claimed to have detected “enterovirus capsid protein vp1″ in 44 out of 72 pancreases from children who had died of type-1 diabetes shortly after becoming ill, but in only three out of 50 neonatal and paediatric normal control specimens. Statistically there is a strong correlation in this study between diabetes and the presence of the virus protein, but a correlation does not indicate a cause. Are diabetics more susceptible to enterovirus infection? We don’t know. While it’s not ethically possible to satisfy Koch’s postulates in humans, we need to be very careful in inferring from small scale studies such as this one:

1. The microorganism must be found in abundance in all organisms suffering from the disease.
2. The microorganism must be isolated from a diseased organism and grown in pure culture.
3. The cultured microorganism should cause disease when introduced into a healthy organism.
4. The microorganism must be reisolated from the inoculated, diseased experimental host and identified as being identical to the original specific causative agent.

There are over a hundred different enteroviruses and the antibody used for detection of virus protein in this study (yes, that’s right, just one non-specific antibody) does not identify the virus involved. Vaccine against diabetes? I don’t think so.

But as I said, we’ve been here before. There are reports of viruses associated with diabetes dating from the 1960s, and a very well known model of Coxsackie virus B4 causing diabetes in mice dating from the 1970s (Coxsackie Viruses and Diabetes Mellitus. BMJ 1973 November 3; 4(5887): 260–262). So does the latest work add anything new, and is a vaccine against diabetes just around the corner? No. I wish it was.

Related:

• Can you have confidence in the news?
• Media coverage affects how people perceive the threat of disease

Tags: Biology, Genetics, Health, Medicine, Microbiology, Podcast, Science, Vaccines, Virology

This entry was posted on Monday, March 16th, 2009 at 9:00 am and is filed under Biology, Genetics, Health, Medicine, Microbiology, Podcast, Science, Vaccines, Virology. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.