Environmental risk factors for type 1 diabetes.
The incidence of type 1 diabetes has risen considerably in the past 30 years due to changes in the environment that have been only partially identified. In this Series paper, we critically discuss candidate triggers of islet autoimmunity and factors thought to promote progression from autoimmunity to overt type 1 diabetes. We revisit previously proposed hypotheses to explain the growth in the incidence of type 1 diabetes in light of current data. Finally, we suggest a unified model in which immune tolerance to β cells can be broken by several environmental exposures that induce generation of hybrid peptides acting as neoautoantigens.
Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO, USA.
Marian
M
Rewers
Division of Pediatrics, Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University and Linköping University Hospital, Linköping, Sweden. Electronic address: johnny.ludvigsson@liu.se.
Johnny
J
Ludvigsson
D000818:Animals; D001324:Autoantigens / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology; D001724:Birth Weight / Q000276:immunology; D001942:Breast Feeding; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology* / Q000276:immunology; D004032:Diet; D004777:Environment; D005231:Fatty Acids, Unsaturated / Q000276:immunology; D006128:Growth / Q000276:immunology; D006801:Humans; D006920:Hygiene; D007223:Infant; D007225:Infant Food; D050417:Insulin-Secreting Cells / Q000276:immunology; D008892:Milk / Q000276:immunology; D012313:RNA / Q000235:genetics; D012307:Risk Factors; D014118:Toxins, Biological / Q000276:immunology; D014612:Vaccines / Q000009:adverse effects; D014807:Vitamin D / Q000276:immunology
D001324:Autoantigens; D005231:Fatty Acids, Unsaturated; D014118:Toxins, Biological; D014612:Vaccines; D014807:Vitamin D; D012313:RNA