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Type I Diabetes Mellitus: Genetic Factors and Presumptive Enteroviral Etiology or Protection

DOI: 10.1155/2014/738512

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Abstract:

We review type 1 diabetes and host genetic components, as well as epigenetics and viruses associated with type 1 diabetes, with added emphasis on the enteroviruses, which are often associated with triggering the disease. Genus Enterovirus is classified into twelve species of which seven (Enterovirus A, Enterovirus B, Enterovirus C, and Enterovirus D and Rhinovirus A, Rhinovirus B, and Rhinovirus C) are human pathogens. These viruses are transmitted mainly by the fecal-oral route; they may also spread via the nasopharyngeal route. Enterovirus infections are highly prevalent, but these infections are usually subclinical or cause a mild flu-like illness. However, infections caused by enteroviruses can sometimes be serious, with manifestations of meningoencephalitis, paralysis, myocarditis, and in neonates a fulminant sepsis-like syndrome. These viruses are often implicated in chronic (inflammatory) diseases as chronic myocarditis, chronic pancreatitis, and type 1 diabetes. In this review we discuss the currently suggested mechanisms involved in the viral induction of type 1 diabetes. We recapitulate current basic knowledge and definitions. 1. History of Diabetes Symptoms of type 1 diabetes (T1D) have been recognized since approximately 1500?BC, when they were described on Egyptian papyrus as indicators of a rare disease that caused patients to lose weight rapidly and experience “too great emptying of the urine” [1, 2]. This was probably the first mention of the disease. At approximately the same time, however, Indian physicians realized that the urine of some patients attracted ants. These doctors classified the disease and named it “madhumeha” or “honey urine” [3]. Later, the disease was called “diabetes” by Greek physician Aretaeus, who noted symptoms such as constant thirst, excessive urination, and loss of weight. “Diabetes” comes from the Greek word for “siphon” (to draw off or convey liquid). The Arabian physician Avicenna (980–1037) was the first to bring attention to the complexity and progression of the disease, recognizing primary and secondary diabetes. In the 17th century, the Latin term “mellitus” meaning “honeyed” or “sweet” was added by Thomas Willis, an English physician, in his treatise Pharmaceutice Rationalis?(1674). He tested urine samples of patients to determine the presence of diabetes; those samples with a sweet taste indicated diabetes mellitus or “honeyed” diabetes. In 1776, Matthew Dobson measured the quantity of glucose in the urine samples of diabetic patients. Dr. Frederick Allen, a diabetes specialist in the early 20th

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