VIRAL TRIGGERS IN TYPE 1 DIABETES - CONTROVERSY AND PROSPECTS OF A NEW VIRUS ASSOCIATED WITH T1DM

Type 1 diabetes mellitus is a multifactorial disease with poorly understood etiology. Viral infections have been proposed as important environmental factors contributing to type 1 diabetes mellitus pathogenesis. The physiopathological mechanisms by which viruses may act are related to the promotion or acceleration of autoimmunity and are mostly speculative. These mechanisms were mostly hypothesized in the context of infections with enteroviruses such as Coxsackievirus B. These mechanisms include direct cellular injury, molecular mimicry, bystander activation and delayed viral clearance. A new group of human-infecting viruses classified in the Anelloviridae family, namely torque teno viruses, are emerging infectious agents with unknown pathogenicity. Human anelloviruses are highly prevalent world-wide and exhibit host pantropism. Recent studies started shedding light on potential mechanisms by which these viruses may modulate host's immune system, thus potentially contributing to autoimmunity. The purpose of our study was to review some of the mechanisms by which viruses may contribute to the pathogenicity of type 1 diabetes mellitus and to introduce the hypotheses of new viral agents possibly associated with this condition.