Pathogenesis of type 1 diabetes: lessons from natural history studies of high-risk individuals.
Type 1 diabetes (T1D) is an autoimmune disease characterized by known genetic risk factors with T cell-mediated infiltration and destruction of the beta cells within pancreatic islets. Autoantibodies are the most significant preclinical marker of T1D, and birth cohort studies have provided important insights into the natural history of autoimmunity and T1D. While HLA remains the strongest genetic risk factor, a number of novel gene variants associated with T1D have been found through genome-wide studies, some of which have been linked to suspected environmental risk factors. Multiple environmental factors that have been suggested to play a role in the development of T1D await confirmation. Current risk-stratification models for T1D take into account genetic risk factors and autoantibodies. In the future, metabolic profiles, epigenetics, as well as environmental risk factors may be included in such models.
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA. Natalie.Nokoff@childrenscolorado.org
Natalie
N
Nokoff
Marian
M
Rewers
D000818:Animals; D001323:Autoantibodies / Q000096:biosynthesis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000235:genetics* / Q000276:immunology; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006680:HLA Antigens / Q000096:biosynthesis; D006801:Humans; D012307:Risk Factors
D001323:Autoantibodies; D006680:HLA Antigens