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Pathogenesis of type 1 diabetes: lessons from natural history studies of high‐risk individuals
Author(s) -
Nokoff Natalie,
Rewers Marian
Publication year - 2013
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.12021
Subject(s) - pathogenesis , natural history , type 2 diabetes , natural (archaeology) , medicine , diabetes mellitus , bioinformatics , immunology , biology , endocrinology , paleontology
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.