It is the current opinion that pathogens, such as bacteria and viruses, could contribute to the development of Type 1 Diabetes (T1D) in susceptible individuals on the base of epidemiological associations and direct isolation of micro-organisms. Moreover prospective studies supposed chronic inflammation as a risk factor for Type 2 Diabetes (T2D). Human enteroviruses (HEV) emerged as prime suspects, because of detection frequencies around clinical onset and their ability to rapidly trigger hyperglycemia. Arguments in favour and opposed to a viral involvement in the pathogenesis of T1D have been proposed. Controversial is the role of Helicobacter pilori in the diabetes onset too. Several Authors from the Netherlands, Italy, Turkey, and Africa reported a positive association between H. pylori infection and T2D but, whether H. pylori could induce a defect in insulin secretion remains speculative. Recent findings linked diabetes to Crohn's disease, since they found Mycobacterium avium subspecies paratuberculosis (Map) bacteremia involved with autoimmune diabetes. Its association with T1D has been recently proposed but specific immunoassays did not confirm the association of Map with T2D. The zoonotic potential of Map has been debated for almost a century due to apparent clinical and pathological similarities between Johne’s Disease (JD) in ruminants and Crohn’s Disease (CD) in humans. Paratuberculosis is a chronic, wasting and incurable granulomatous enteritis that occurs worldwide with increasing frequency. Due to the negative impact of JD on animal production and the potential public health risk through the consumption of milk contaminated with Map, government agencies are considering control programs and targeted microbial testing of milk at processing. Consumption of contaminated milk early in life is a recognized risk factor in the development of these diseases; moreover the ingestion of contaminated cheese manufactured from raw ovine and bovine milk might lead to transmission of Map to humans. Furthermore, the effect of time/temperature conditions during pasteurization on the viability of Map provide firm evidence that this organism is sometimes able to survive to commercial milk pasteurization. Nowadays clinical studies are deciphering the role of chronic bacterial infection in the development of autoimmune diseases such as T1D by rapidly identification of infectious agents, such as Map in diabetic patients. Thus, a comprehensive understanding of Map prevalence, incidence and epidemiological patterns in animals is of tangible value to facilitate the design of prevention and control programmes to reduce Map infection and subsequent transmission to humans.

The role of viruses, bacteria, and Mycobacterium avium subspecies paratuberculosis infection in the etiology of Diabetes Mellitus.

ATTILI, Annarita;CUTERI, Vincenzo
2014-01-01

Abstract

It is the current opinion that pathogens, such as bacteria and viruses, could contribute to the development of Type 1 Diabetes (T1D) in susceptible individuals on the base of epidemiological associations and direct isolation of micro-organisms. Moreover prospective studies supposed chronic inflammation as a risk factor for Type 2 Diabetes (T2D). Human enteroviruses (HEV) emerged as prime suspects, because of detection frequencies around clinical onset and their ability to rapidly trigger hyperglycemia. Arguments in favour and opposed to a viral involvement in the pathogenesis of T1D have been proposed. Controversial is the role of Helicobacter pilori in the diabetes onset too. Several Authors from the Netherlands, Italy, Turkey, and Africa reported a positive association between H. pylori infection and T2D but, whether H. pylori could induce a defect in insulin secretion remains speculative. Recent findings linked diabetes to Crohn's disease, since they found Mycobacterium avium subspecies paratuberculosis (Map) bacteremia involved with autoimmune diabetes. Its association with T1D has been recently proposed but specific immunoassays did not confirm the association of Map with T2D. The zoonotic potential of Map has been debated for almost a century due to apparent clinical and pathological similarities between Johne’s Disease (JD) in ruminants and Crohn’s Disease (CD) in humans. Paratuberculosis is a chronic, wasting and incurable granulomatous enteritis that occurs worldwide with increasing frequency. Due to the negative impact of JD on animal production and the potential public health risk through the consumption of milk contaminated with Map, government agencies are considering control programs and targeted microbial testing of milk at processing. Consumption of contaminated milk early in life is a recognized risk factor in the development of these diseases; moreover the ingestion of contaminated cheese manufactured from raw ovine and bovine milk might lead to transmission of Map to humans. Furthermore, the effect of time/temperature conditions during pasteurization on the viability of Map provide firm evidence that this organism is sometimes able to survive to commercial milk pasteurization. Nowadays clinical studies are deciphering the role of chronic bacterial infection in the development of autoimmune diseases such as T1D by rapidly identification of infectious agents, such as Map in diabetic patients. Thus, a comprehensive understanding of Map prevalence, incidence and epidemiological patterns in animals is of tangible value to facilitate the design of prevention and control programmes to reduce Map infection and subsequent transmission to humans.
2014
9781922227478
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11581/271793
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