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Molecular aspects of type 1 diabetes

Department of Medicine, Division of Medical Sciences, University of Birmingham and Birmingham Heartlands Hospital, Birmingham B9 5SS, UK

Correspondence to:
Dr M A Kelly, Department of Medicine, Clinical Research Block, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK;
m.a.kelly{at}bham.ac.uk

ABSTRACT
Type 1 diabetes is a T cell mediated autoimmune disease, characterised by the selective destruction of pancreatic ß cells, and susceptibility is determined by a combination of genetic and environmental factors. The environmental agents implicated include viruses and dietary factors, although none has yet been shown to be directly responsible for triggering ß cell autoimmunity. The genetic factors that influence disease risk have been subjected to more intensive study and two gene regions of major importance have been identified: the human leucocyte antigen locus and the insulin gene. This review will focus on the mechanisms by which these genes might influence the risk of developing type 1 diabetes.

Keywords: type 1 diabetes; HLA molecules; molecular mechanisms

Abbreviations: GAD, glutamic acid decarboxylase; HLA, human leucocyte antigen; IDDM, insulin dependent diabetes mellitus; IGF, insulin-like growth factor; MHC, major histocompatibility complex; NOD, non-obese diabetic; TCR, T cell receptor; VNTR, variable number of tandem repeats

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