Rotavirus infection may play a role in the development of type 1 diabetes, according to a front matter article published October 10 in the open-access journal PLOS Pathogens by Leonard C. Harrison of the University of Melbourne in Australia, and colleagues.
Rotavirus remains the major cause of infantile gastroenteritis worldwide, although the advent of vaccination has substantially decreased associated mortality. Following the recent introduction of rotavirus vaccination, there has been a 15% decrease in the incidence of type 1 diabetes in Australian children under four years of age, suggesting that rotavirus vaccination could contribute to the primary prevention of this autoimmune disease. This finding complements human and animal studies implicating rotavirus in the development of type 1 diabetes in genetically susceptible children.
In the article, Harrison and colleagues begin by reviewing molecular evidence supporting their hypothesis and point out the association between rotavirus infection and serum islet autoantibodies. They also discuss results indicating that rotavirus infection induces pancreatic pathology, as well as environmental factors that promote the rise in incidence of type 1 diabetes. Finally, they review population-level data suggesting that rotavirus vaccination may be associated with a decrease in the incidence of type 1 diabetes. According to the authors, it will be important to identify which children are most likely to be protected by rotavirus vaccination. Moreover, future studies should aim to reveal disease mechanisms and directly demonstrate whether rotavirus infects the human pancreas prior to the onset of islet autoimmunity or type 1 diabetes.
Harrison concludes, "Vaccination against rotavirus may have the additional benefit in some children of being a primary prevention for type 1 diabetes."
Funding: LCH was the recipient of a Senior Principal Research Fellowship from the National Health & Medical Research Council of Australia (NHMRC; APP1080887; http://www.nhmrc.gov.au) and a generous donation from the Colin North Diabetes Fund (LCH). KPP was the recipient of a Melbourne Children's Clinician-Scientist Fellowship and Murdoch Children's Research Institute Infection and Immunity Theme Grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Harrison LC, Perrett KP, Jachno K, Nolan TM, Honeyman MC (2019) Does rotavirus turn on type 1 diabetes? PLoS Pathog 15(10): e1007965. https://doi.org/10.1371/journal.ppat.1007965
Walter and Eliza Hall Institute for Medical Research, University of Melbourne, Melbourne, Victoria, Australia Vaccine and Immunization Research Group, Murdoch Children's Research Institute and the Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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