Unraveling the Interplay: Viruses, Hormones, and Metabolic Disorders

Is There a Connection Between Viruses, Hormones, and Metabolic Diseases?

During the 67th Congress of the German Society of Endocrinology, Professor Stefan Bornstein proposed the concept of the virome as an additional metabolically active gland, underscoring the growing evidence of interactions between hormone systems and infectious agents. This suggests that infectious diseases could potentially serve as triggers for the onset of diabetes and other metabolic disorders, prompting discussions on the potential role of vaccination programs in preventing the spread of these so-called “non-communicable diseases”. If further research corroborates these findings, it could challenge the classification of diabetes and similar conditions as “non-communicable diseases,” presenting a paradoxical scenario.

Bornstein highlighted findings from individuals severely affected by COVID-19 during the pandemic, noting a correlation between the virus and diabetes or pre-metabolic syndrome. He emphasised that SARS-CoV-2 exploits endocrine signalling pathways to invade cells and induce organ damage and inflammation. Furthermore, evidence suggests that infections from coronaviruses and other pathogens like influenza can exacerbate existing metabolic conditions, including diabetes and various endocrine disorders.

SARS-CoV-2’s Impact on Insulin-Secreting Beta Cells

Research conducted during the COVID-19 pandemic revealed a heightened risk of developing type 1 diabetes following SARS-CoV-2 infection. In 2021, Bornstein’s team demonstrated that the virus can infect the insulin-secreting beta cells of the pancreas. Through various analytical techniques, they observed viral infiltration into beta cells among COVID-19 patients, even in the absence of newly diagnosed diabetes. This viral presence, along with indications of necroptotic cell death and immune cell infiltration, suggests a potential link between COVID-19 and metabolic disturbances.

In an October 2020 report, Tim Hollstein, MD, and colleagues documented a case involving a 19-year-old man who developed insulin-dependent diabetes following a SARS-CoV-2 infection. Despite lacking autoantibodies typically associated with type 1 diabetes, the individual presented with diabetic ketoacidosis, indicating a significant impact on glucose metabolism post-infection.

Viruses Generating Insulin-Like Proteins

Recent studies have highlighted the ability of certain viruses to produce insulin-like proteins or hormones, disrupting metabolic processes within the host organism. Antiviral therapies may delay the onset of type 1 diabetes by preserving beta cell function. Additionally, conventional treatments for hormonal imbalances, such as DPP-4 inhibitors and metformin, have shown promise in reducing susceptibility to infections.

Understanding Viruses’ Influence on Metabolic Diseases

Viruses can promote metabolic disorders by influencing critical signalling pathways involved in cell survival, proliferation, and apoptosis and by altering glucose metabolism in infected cells. Enteroviruses and other pathogens have been linked to diabetes onset, suggesting a complex interplay between viral infections and genetic predispositions.

Metabolic Diseases’ Impact on Infection

Conversely, infections like hepatitis C virus (HCV) are associated with a higher risk of type 2 diabetes, particularly among older individuals with a family history of the disease. HCV disrupts glucose regulation by increasing insulin resistance in the liver, affecting glucose uptake and insulin signalling pathways.

Immune System Alterations in Metabolic Conditions

Individuals with obesity, diabetes, or insulin resistance often exhibit changes in innate and adaptive immune functions, including compromised neutrophil activity and altered cytokine secretion in adipose tissue. Moreover, studies have shown delayed immune responses to respiratory viruses in insulin-resistant individuals.

Understanding the intricate relationship between viruses, hormones, and metabolic diseases is crucial for developing effective prevention and treatment strategies for these interconnected health issues.

Written by Mr. Shazlee Ashan

BSc Pharmacy, MSc Endocrinology, PgDip Infectious Diseases, Ipresc