title: Lessons from type 1 diabetes for understanding natural history and prevention of autoimmune disease.
abstract: Type 1 diabetes (T1D) is a chronic autoimmune disorder resulting from immune-mediated destruction of insulin-producing beta cells within the pancreatic islets. Prediction of T1D is now possible, as having 2 or more islet autoantibodies confers a 100% risk of diabetes development. With the ability to predict disease development, clinical trials to prevent diabetes onset have been completed and are currently under way. This review focuses on the natural history, prediction, and prevention trials in T1D. We review the lessons learned from these attempts at preventing a chronic autoimmune disease and apply the paradigm from T1D prevention to other autoimmune disorders.
authors.affiliation: Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, 1775 Aurora Court, Aurora, CO 80045, USA.
authors.forename: Kimber
authors.initials: K
authors.lastname: Simmons
authors.affiliation: Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, 1775 Aurora Court, Aurora, CO 80045, USA. Electronic address: Aaron.michels@ucdenver.edu.
authors.forename: Aaron W
authors.initials: AW
authors.lastname: Michels
mesh_terms: D000069594:Abatacept; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology*; D001327:Autoimmune Diseases / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology / Q000517:prevention & control*; D004035:Diet Therapy; D018450:Disease Progression; D061345:Early Medical Intervention; D020022:Genetic Predisposition to Disease; D006681:HLA-D Antigens / Q000235:genetics*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D018796:Immunoconjugates / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007515:Islets of Langerhans / Q000276:immunology; D009536:Niacinamide / Q000627:therapeutic use; D011322:Primary Prevention / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D055502:Secondary Prevention / Q000379:methods; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001323:Autoantibodies; D006681:HLA-D Antigens; D007004:Hypoglycemic Agents; D018796:Immunoconjugates; D007166:Immunosuppressive Agents; D007328:Insulin; D014803:Vitamin B Complex; D009536:Niacinamide; D000069594:Abatacept; C502540:teplizumab
keywords: Autoantibodies; Autoimmunity; Immune therapies; Prevention; Type 1 diabetes