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NDT Advance Access originally published online on July 26, 2005
Nephrology Dialysis Transplantation 2005 20(11):2311-2315; doi:10.1093/ndt/gfi033
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Is there a link between cytomegalovirus infection and new-onset posttransplantation diabetes mellitus? Potential mechanisms of virus induced ß-cell damage

Jøran Hjelmesæth1, Fredrik Müller2, Trond Jenssen1, Halvor Rollag2, Solbjørg Sagedal1 and Anders Hartmann1

1 Department of Medicine, Section of Nephrology and 2 Institute of Medical Microbiology, Rikshospitalet University Hospital, 0027 Oslo, Norway

Correspondence and offprint requests to: Jøran Hjelmesæth, Department of Medicine, the Hospital in Vestfold HF, Boks 2168, 3103 Tønsberg, Norway. Email: joran@online.no

Keywords: cytomegalovirus infection; posttransplantation diabetes mellitus; risk factor

The first 150 words of the full text of this article appear below.



   Introduction
 
Several types of viral infections have been associated with increased risk of diabetes mellitus [1,2]. Enteroviruses are among the most studied environmental triggers of type 1 diabetes, but also other viruses such as the rubella virus, mumps virus, Epstein–Barr virus, varicella zoster virus and cytomegalovirus (CMV) have been suggested to be associated with type 1 diabetes [1].

Recently, hepatitis C virus (HCV) has emerged as an important risk factor of type 2 diabetes and new-onset posttransplantation diabetes mellitus (PTDM) [2]. Insulin resistance secondary to hepatic steatosis, or elevated levels of pro-inflammatory cytokines such as TNF-{alpha} [2], may explain the latter relationship. Others have argued that both insulin resistance and insulinopaenia are involved in the pathogenesis of HCV-associated glucose intolerance [3].

In the present article we address a possible relation between CMV infection and new-onset PTDM in renal transplant . . . [Full Text of this Article]



   Association between CMV infection and new-onset PTDM
 
Association between CMV infection and PTDM
Immunosuppressive drugs
Hepatitis C and CMV


   Possible pathogenetic mechanisms of CMV induced ß-cell damage
 
CMV infection of ß-cells
Cytotoxic effects by infiltrating leukocytes
Cytokines


   Implications for therapy and/or prophylaxis?
 


   Conclusions
 

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