Herold, Kevan C; Delong, Thomas; Perdigoto, Ana Luisa; Biru, Noah; Brusko, Todd M; Walker, Lucy SK; (2024) The immunology of type 1 diabetes. Nature Reviews Immunology , 24 pp. 435-451. 10.1038/s41577-023-00985-4.

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Abstract

Following the seminal discovery of insulin a century ago, treatment of individuals with type 1 diabetes (T1D) has been largely restricted to efforts to monitor and treat metabolic glucose dysregulation. The recent regulatory approval of the first immunotherapy that targets T cells as a means to delay the autoimmune destruction of pancreatic β-cells highlights the critical role of the immune system in disease pathogenesis and tends to pave the way for other immune-targeted interventions for T1D. Improving the efficacy of such interventions across the natural history of the disease will probably require a more detailed understanding of the immunobiology of T1D, as well as technologies to monitor residual β-cell mass and function. Here we provide an overview of the immune mechanisms that underpin the pathogenesis of T1D, with a particular emphasis on T cells.

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