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Diabet Med. 2013 Feb;30(2):147-54. doi: 10.1111/dme.12085.

Immunological pathways to β-cell damage in Type 1 diabetes.

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Department of Immunobiology, King's College London, School of Medicine and National Institute of Health Research Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust and King's College, London, UK.


Following almost 30 years of intensive research, initiated by the observation that Type 1 diabetes development is associated with a characteristic pancreatic immune cell infiltrate, a picture is emerging of which of the diverse effector arms of the immune system are involved in β-cell destruction. Like any chronic pathology, there is considerable complexity, and our ability to model the disease is hampered by a lack of ready access to the target organ and limited longitudinal analyses. However, it seems that putative pathways can start to be ruled in and out, in part as a result of focused mechanistic studies that make use of new technologies, and in part through analysis of the outcomes of clinical trials of new agents aimed at halting the disease process. The picture that emerges suggests a pathway to prevention that may require combinations of therapeutic agents that target different aspects of the immune system and will need to be used with due attention to their risk-benefit profiles.

[Indexed for MEDLINE]

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