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Our aim was to study the possible associations of 10 different microbial infections with islet autoimmunity in a large international prospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In a nested case\u2010control study within the TRIGR study, follow\u2010up serum samples from 240 islet autoantibody\u2010positive case children and 436 age\u2010 and country\u2010matched control children were analysed for IgG class antibodies against 10 different respiratory and gastrointestinal microbes using an enzyme immunoassay, and for neutralising antibodies against all six coxsackievirus B types. The samples were obtained at several time points prior to and at the time of seroconversion for multiple islet autoantibodies. All children had a first\u2010degree relative with type 1 diabetes, and they carried risk\u2010associated HLA\u2010DQ alleles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Coxsackievirus B5 was associated with an increased risk of islet autoimmunity (OR 2.22, 95% CI 1.29\u20133.80,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004, corrected\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.024), which remained after adjustment for HLA, sex, and maternal type 1 diabetes. This association was particularly seen for infections occurring more than 12\u00a0months (OR 2.02, 95% CI 1.06\u20133.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.032) and 0\u20136\u00a0months (OR 2.66, 95% CI 1.11\u20136.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.028) before the first detection of multiple islet autoantibodies. After correction for multiple comparisons, none of the other viruses showed an association with islet autoimmunity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study supports previous evidence of the risk association of coxsackievirus B infections. These results support the role of certain virus infections as possible modulating factors in the pathogenesis of type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70207","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:19:24Z","timestamp":1785323964000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coxsackievirus B Infections Are Associated With the Risk of Islet Autoimmunity in Children With Strong Genetic Susceptibility to Type 1 Diabetes\u2014Results From the TRIGR Divia Study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1329-1508","authenticated-orcid":false,"given":"Maarit","family":"Oikarinen","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5538-5153","authenticated-orcid":false,"given":"Amirbabak","family":"Sioofy\u2010Khojine","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-8654","authenticated-orcid":false,"given":"Leena","family":"Puustinen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3785-9834","authenticated-orcid":false,"given":"David","family":"Cuthbertson","sequence":"additional","affiliation":[{"name":"Health Informatics Institute Morsani College of Medicine University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussi","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niila V. V.","family":"Jouppila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1695-5234","authenticated-orcid":false,"given":"Johnny","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Division of Pediatrics, Crown Princess Victoria Children's Hospital Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7115-6035","authenticated-orcid":false,"given":"Leena","family":"Hakola","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences Unit of Health Sciences Tampere University  Tampere Finland"},{"name":"Tampere University Hospital, Wellbeing Services County of Pirkanmaa  Tampere 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