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Molecular and Cellular Pediatric Endocrinology pp 271–296Cite as

Molecular and Cellular Basis of Immune-Mediated (Type 1) Diabetes

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Part of the book series: Contemporary Endocrinology ((COE,volume 10))

Abstract

Immune-mediated (type I) diabetes (IMD), a multifactorial autoimmune disease, is determined by both environmental and genetic factors (1). Lymphocytic infiltration of pancreatic islets (insulitis) is the hallmark of the disease (2,3). The infiltration of islets proceeds slowly and has most times been present for years before the clinical diagnosis (4–6). Studies suggest that the autoimmune process that leads to IMD often begins during the first few years of life (7,8). The inflammatory infiltrate of islets consists mostly of CD8+ T cells plus variable numbers of CD4+ T cells, B-lymphocytes, macrophages, and natural killer cells (3). Massive β cell destruction by infiltrating cells, however, could be a late event in the process, which results in symptomatic diabetes only when at least 80% of the volume of beta cells have been destroyed (3). The destruction is mainly mediated by T cells. However, it is accompanied by circulating marker, islet cell autoantibodies (ICA) to pancreatic β-cells proteins (9,10), which can be used to predict the disease.

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  1. Division of Endocrinology, Children’s Hospital Medical Center, Cincinnati, OH, USA

    Stuart Handwerger MD

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© 1999 Springer Science+Business Media New York

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Coutant, R., MacLaren, N.K. (1999). Molecular and Cellular Basis of Immune-Mediated (Type 1) Diabetes. In: Handwerger, S. (eds) Molecular and Cellular Pediatric Endocrinology. Contemporary Endocrinology, vol 10. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-697-3_16

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  • DOI: https://doi.org/10.1007/978-1-59259-697-3_16

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5875-7

  • Online ISBN: 978-1-59259-697-3

  • eBook Packages: Springer Book Archive

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