Type 1 diabetes: pathogenesis and prevention

Gillespie, Kathleen M.
July 2006
CMAJ: Canadian Medical Association Journal;7/18/2006, Vol. 175 Issue 2, p165
Academic Journal
Type 1 diabetes results from the autoimmune destruction of insulin-producing β cells in the pancreas. Genetic and, as yet undefined, environmental factors act together to precipitate the disease. The excess mortality associated with the complications of type 1 diabetes and the increasing incidence of childhood type 1 diabetes emphasize the importance of therapeutic strategies to prevent this chronic disorder. Why is it considered that type 1 diabetes might be preventable? Different strands of diabetes research are coming together to suggest therapeutic targets. Islet cell auto-antibody assays make it possible to accurately identify people at risk of future disease. In most cases, a long prodrome provides a window of opportunity to reverse the autoimmune process. Although no current "cure" exists, recent genetic data and preliminary trial results suggest T cells as a target for preventive strategies. Another potentially attainable target is induction of tolerance to the β-cell proteins such as insulin that are inappropriately recognized. Other strategies involve β-cell replacement, but currently there are insufficient donor cells available. This may be overcome as the processes controlling the differentiation of pancreatic and nonpancreatic progenitors as well as replication of existing islet β cells are unravelled.


Related Articles

  • Insulin as a primary autoantigen for type 1A diabetes. Jasinski, J. M.; Eisenbarth, G. S. // Clinical & Developmental Immunology;Sep2005, Vol. 12 Issue 3, p181 

    Type 1A diabetes mellitus is caused by specific and progressive autoimmune destruction of the beta cells in the islets of Langerhans whereas the other cell types in the islet (alpha, delta, and PP) are spared. The autoantigens of Type 1A diabetes may be divided into subgroups based on their...

  • The Devil We Know. Butterfield, Deb // Diabetes Health;Jul2004, Vol. 13 Issue 7, p11 

    Focuses on several health issues. Autoimmune attack in type 1 diabetes; Information on the beta-cell replacement therapy used for treating diabetes; Discussion on the Edmonton protocol for islet transplantation.

  • T-Cell Responses to Islet Antigens Improves Detection of Autoimmune Diabetes and Identifies Patients With More Severe β-Cell Lesions in Phenotypic Type 2 Diabetes. Goel, Amit; Chiu, Harvey; Felton, Jamie; Palmer, Jerry P.; Brooks-Worrell, Barbara // Diabetes;Aug2007, Vol. 56 Issue 8, p2210 

    Latent autoimmune diabetes in adults or type 1.5 diabetes is considered to be a T-cell-mediated autoimmune disease. However, identification of patients is based commonly on autoantibody (Ab) detection. To determine whether measuring T-cell reactivity to islet proteins compared with measuring Abs...

  • Flow Cytometric Studies of Islet Cell Numbers and Mitotic Activity During Beta Cell-Specific Autoimmunity and Diabetes Development. Pechhold, Klaus; Zhu, Xiaolong; Lee, Janet; Liu, Eric; Harlan, David M. // Diabetes;Jun2007 Supplement 1, Vol. 56, pA427 

    Type 1 diabetes occurs when autoreactive T cells have destroyed most pancreatic insulin-producing beta cells. Current data suggests that in both rodent models and in Man, T cell-mediated diabetes is primarily beta cell antigen-specific, and yet the fate of non-beta cells during the immunological...

  • Molecular Basis of Islet Regeneration in NOD Mice Following Adjuvant Treatment. Huszarik, Katrina L.; Krougly, Olga; Singh, Bhagirath // Diabetes;Jun2007 Supplement 1, Vol. 56, pA418 

    Type 1 Diabetes (T1D) is characterized by autoimmune destruction of the insulin producing beta cells in the pancreatic islets. Our previous studies have shown that treatment with complete Freund's adjuvant (CFA) prevents diabetes and islet destruction in NOD mice by downregulating and/or...

  • EXPLORING THE ANTIGENIC SPECIFICITIES OF CD8[sup +] T CELLS INVOLVED IN THE EARLY PATHOGENEICS OF AUTOIMMUNE DIABETES. Lieberman, S.M.; DiLorenzon, T.P. // Einstein Quarterly: Journal of Biology & Medicine;2002, Vol. 19 Issue 4, p184 

    T cell infiltration of pancreatic islets followed by the selective destruction of pancreatic islet β cells characterizes autoimmune diabetes. In the nonobese diabetic (NOD) mouse model of autoimmune diabetes, a model that shares several characteristics with the human disease, both CD8[sup +]...

  • Extracellular Matrix Components Protect Human Beta Cells Against Cell Death. Cechin, Sirlene R.; Gonzalez-Quintana, Jorge; Ochoa, Maria Sofia; Perez-Alvarez, Ingrid; Ichii, Hirohito; Ricordi, Camillo; Inverardi, Luca; Fenjves, Elizabeth // Diabetes;Jun2007 Supplement 1, Vol. 56, pA410 

    Type I diabetes is an autoimmune disease resulting in loss of the insulinproducing beta cells. Islet transplantation can reestablish regulated insulin secretion in patients with type I diabetes but the shortage of islets limits this approach. Enzymatic digestion during islet isolation is poorly...

  • Taurine supplement in early life altered islet morphology, decreased insulitis and delayed the onset of diabetes in non-obese diabetic mice. Arany, E.; Strutt, B.; Romanus, P.; Remacle, C.; Reusens, B.; Hill, D. J. // Diabetologia;Oct2004, Vol. 47 Issue 10, p1831 

    Aims/hypothesis. We hypothesised that nutritional tau- rifle, which is important for the development of the endocrine pancreas and reduces cytokine-induced apoptosis in pancreatic beta cells, would prevent or delay the onset of autoimmune diabetes, if given early in life to the non-obese...

  • New Insights into Autoimmune Diabetes in Mice from Proteomics and Genomics Studies. Gerling, Ivan C.; Lenchik, Nataliya I.; Wu, Jian // Diabetes;Jun2007 Supplement 1, Vol. 56, pA643 

    NOD mice develop clear signs of leukocyte infiltration around their islets of Langerhans as early as age 5 weeks. Our studies focus on the molecular networks and processes preceding that pathological stage. Mononuclear spleen leukocytes were collected from NOD and control mouse strains (NON and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics