Premium
The potential of multimer technologies in type 1 diabetes prediction strategies
Author(s) -
Fierabracci Alessandra
Publication year - 2011
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.1165
Subject(s) - autoantibody , immunology , immune system , disease , type 1 diabetes , islet , t cell , autoimmune disease , cd8 , antigen , autoimmunity , major histocompatibility complex , human leukocyte antigen , medicine , acquired immune system , beta cell , biology , diabetes mellitus , antibody , endocrinology
Type 1 diabetes is an autoimmune disease which occurs in (human leukocyte antigen) genetically predisposed individuals as a consequence of the organ‐specific immune destruction of the insulin‐producing β cells in the islets of Langherans within the pancreas. Type 1 diabetes is the result of a breakdown in immune regulation that leads to expansion of autoreactive CD4+ and CD8+ T cells, autoantibody‐producing B lymphocytes and activation of the innate immune system. Islet‐related autoantibodies revealed themselves to be good predictors of future onset of the disease, although they are not directly pathogenetic; T cells instead play a dominant role in disease initiation and progression. In this review, we first discuss the approaches that several laboratories attempted to measure human islet autoantigen‐specific T‐cell function in type 1 diabetes. T‐cell assays could be used in combination with standardized autoantibody screenings to improve predictive strategies. They could also help to monitor in long‐term follow‐up the efficacy of tolerogenic immunotherapeutic strategies when established at the onset of the disease, and help to predict the recurrence of disease. Although some recent developments based on enzyme‐linked immunosorbent spot and immunoblotting techniques have been able to distinguish with good sensitivity and specificity patients from controls, T‐cell results, as revealed by international workshops, were indeed largely inconclusive. Nowadays, novel technologies have been exploited that could contribute to answering the tantalizing question of identifying autoreactive T cells. We particularly focus on and discuss MHC multimer tools and emphasize the advantages they can offer but also their weaknesses when used in combination with other T‐cell assays. Copyright © 2011 John Wiley & Sons, Ltd.