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lüll Role of coxsackievirus B4 in the pathogenesis of type 1 diabetes Jaidane H; Hober DDiabetes Metab 2008[Dec]; 34 (6 Pt 1): 537-48Environmental factors, especially viruses, are thought to play an important role in the initiation or acceleration of the pathogenesis of type 1 diabetes (T1D). Data from retrospective and prospective epidemiological studies strongly suggest that enteroviruses, such as coxsackievirus B4 (CV-B4), may be associated with the development of T1D. It has also been shown that enterovirus infections are significantly more prevalent in at-risk individuals such as the siblings of diabetic patients, when they develop anti-beta-cell autoantibodies or T1D, and in recently diagnosed diabetic patients, compared with control subjects. The isolation of CV-B4 from the pancreas of diabetic patients supports the hypothesis of a relationship between the virus and the disease. Furthermore, studies performed in vitro and in vivo in animal models have increased our knowledge of the role of CV-B4 in T1D by helping to clarify the pathogenic mechanisms of the infection that can lead to beta-cell destruction, including direct virus-induced beta-cell lysis, molecular mimicry, 'bystander activation' and viral persistence. The role of enteroviruses as the sole agents in T1D, and a causal link between these agents and T1D, have not yet been established, although arguments that support such a role for these viruses in the pathogenesis of the disease cannot be ignored.|*Enterovirus B, Human/pathogenicity/physiology[MESH]|Animals[MESH]|Bystander Effect[MESH]|Coxsackievirus Infections/*complications[MESH]|Diabetes Mellitus, Type 1/epidemiology/*virology[MESH]|Disease Models, Animal[MESH]|Humans[MESH]|Insulin-Secreting Cells/pathology/virology[MESH]|Prospective Studies[MESH]|Retrospective Studies[MESH]|Virus Replication[MESH] |