Antigenic determinants in type 1 diabetes mellitus. Review article

Type 1 diabetes mellitus (IDDM) is a disease caused by the autoimmune destruction of insulin-producing pancreatic beta cells that takes place in genetically predisposed individuals. The results of the studies performed so far during the search for "the target antigen" in beta cell autoimmunity have indicated that, unlike many autoimmune disorders, type 1 diabetes appears to be the result of an autoimmune response to a multiplicity of autoantigens. Autoantibodies and autoreactive T lymphocytes reacting with islet target molecules of protein or glycolipid nature have been shown in the circulation of individuals and of animal models of type 1 diabetes (NOD mouse and BB rat) before and at the onset of the disease. In the present article we have reviewed the data available on the antigenic determinants in type 1 diabetes, with particular reference to those recognized by autoantibodies which represent the best available predictive marker of future disease development in large scale screening studies.