title: T-cell responses to autoantigens in IDDM. The search for the Holy Grail.
abstract: IDDM (type I diabetes) is generally believed to result from T-cell-mediated autoimmune destruction of the insulin-producing beta-cells in the pancreatic islets of Langerhans. In the last few years, considerable progress has been made with regard to the identification and characterization of candidate autoantigens recognized by autoantibodies; several of these candidate autoantigens are recognized by T-cells, including insulin, GAD65 and GAD67, heat-shock protein 65 (hsp65), and islet-cell antigen 69 (ICA69). In addition to these, a number of unidentified beta-cell antigens, including insulin-secretory granule membrane proteins and a 38-kDa protein, have been shown to stimulate T-cells of IDDM patients. However, T-cell autoreactivity to islet antigens is not specific for IDDM, and the T-cell target antigens are not specific for beta-cells. Moreover, the autoantigens involved in the initiation of the insulitis must be defined, and the mechanism of the T-cell-dependent beta-cell destruction remains to be unraveled. This review focuses on T-cell autoreactivity in IDDM in humans and the implications of the present knowledge for immunointervention and monitoring of immunotherapeutic trials.
authors.affiliation: Department of Immunohaematology and Blood Bank, University Hospital Leiden, The Netherlands, broep@pobox.leidenuniv.nl
authors.forename: B O
authors.initials: BO
authors.lastname: Roep
mesh_terms: D000818:Animals; D001323:Autoantibodies; D001324:Autoantigens / Q000276:immunology*; D018834:Chaperonin 60 / Q000276:immunology; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007328:Insulin / Q000276:immunology; D007515:Islets of Langerhans / Q000276:immunology; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D018834:Chaperonin 60; D007328:Insulin; C024211:islet cell antibody; D005968:Glutamate Decarboxylase