Challenge

The relationship between infectious diseases and non-communicable diseases (NCDs) has long been observed, yet proving causality has remained a major scientific challenge. One of the most persistent and intriguing associations is between enterovirus (EV) infections, particularly coxsackie B viruses (CVBs) and the development of type 1 diabetes (T1D). While the connection is well-documented, a definitive causal link is yet to be established. Without a clear understanding of how these viruses might trigger autoimmune responses in the pancreas, preventive and therapeutic interventions remain speculative and underdeveloped.

Solutions

ENT1DEP tackles this challenge by applying an advanced, multidisciplinary approach to unravel the biological mechanisms behind EV-related T1D. Combining in-vitro and in-vivo experimentation with access to rare and unique human clinical samples, the project explores how infections may lead to autoimmune destruction of pancreatic β-cells, while leaving other cell types unharmed. The consortium also integrates artificial intelligence and bioinformatics to analyse large data sets and identify biomarkers that may signal individual susceptibility or progression toward disease. Importantly, ENT1DEP benefits from access to clinical trials evaluating EV vaccines and antiviral treatments, which provide real-world data to test mechanistic hypotheses. These studies will help establish why some individuals develop T1D after EV infection while others remain unaffected, as well as how vaccines and antivirals can mitigate that risk. Key findings are expected to include mechanisms of selective β-cell vulnerability, identification of genetic or immunological risk factors, and validation of markers to distinguish vaccine-induced from infection-induced immune responses.

Results

By generating concrete evidence of causality between viral infection and chronic disease, ENT1DEP has the potential to revolutionize how we approach the prevention of T1D and possibly other infection-related NCDs. The project aims to pave the way for early diagnostic tools, enabling clinicians to identify at-risk individuals before symptoms occur. If successful, the findings could support the development of targeted vaccination campaigns or antiviral therapies that could significantly reduce the burden of T1D. Beyond diabetes, the broader scientific insights into infection-driven autoimmunity may extend to other conditions, such as long COVID, thereby offering a wider public health impact. The long-term benefits would include not only better patient outcomes but also reduced healthcare costs across Europe.