Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Jan;183(1):8-15.
doi: 10.1111/cei.12699. Epub 2015 Oct 21.

The case for an autoimmune aetiology of type 1 diabetes

S I Mannering  1   2 , V Pathiraja  1   2 , T W H Kay  1   2
Affiliations
Review

The case for an autoimmune aetiology of type 1 diabetes

S I Mannering et al. Clin Exp Immunol. 2016 Jan.

Abstract

Type 1 diabetes (T1D) develops when there are insufficient insulin-producing beta cells to maintain glucose homeostasis. The prevailing view has been that T1D is caused by immune-mediated destruction of the pancreatic beta cells. However, several recent papers have challenged the long-standing paradigm describing T1D as a tissue-specific autoimmune disease. These authors have highlighted the gaps in our knowledge and understanding of the aetiology of T1D in humans. Here we review the evidence and argue the case for the autoimmune basis of human T1D. In particular, recent analysis of human islet-infiltrating T cells brings important new evidence to this question. Further data in support of the autoimmune basis of T1D from many fields, including genetics, experimental therapies and immunology, is discussed. Finally, we highlight some of the persistent questions relating to the pathogenesis of human type 1 diabetes that remain to be answered.

Keywords: HLA; T cells; aetiology; autoantibody; type 1 diabetes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Summary of evidence for the autoimmune aetiology of human type 1 diabetes.
See this image and copyright information in PMC

References

    1. Gale EA. The discovery of type 1 diabetes. Diabetes 2001; 50:217–26. - PubMed
    1. Donath MY, Hess C, Palmer E. What is the role of autoimmunity in type 1 diabetes? A clinical perspective. Diabetologia 2014; 57:653–5. - PubMed
    1. Ludvigsson J. Is it time to challenge the established theories surrounding type 1 diabetes? Acta Paediatr 2014; 103:120–3. - PubMed
    1. Skog O, Korsgren S, Melhus A, Korsgren O. Revisiting the notion of type 1 diabetes being a T‐cell‐mediated autoimmune disease. Curr Opin Endocrinol Diabetes Obes 2013; 20:118–23. - PubMed
    1. Coppieters KT, Dotta F, Amirian N et al Demonstration of islet‐autoreactive CD8 T cells in insulitic lesions from recent onset and long‐term type 1 diabetes patients. J Exp Med 2012; 209:51–60. - PMC - PubMed