[Autoantigens in type-I diabetes]

The juvenile form of diabetes, type-I diabetes mellitus, is, to our knowledge of today, an autoimmune disease with the hallmark of selective destruction of the insulin-producing beta cells in the endocrine pancreas. The slow, progressive process is in strong contrast with the sudden onset of clinical disease. The identification of target antigens has implications for both, better diagnostic at an earlier time as well as for new forms of therapy such as induction of tolerance or T-cell vaccination. Next to the direct products of the beta cell, insulin and proinsulin, two antigens of 38 resp. 64 kD molecular weight, have been identified. Other possible antigens include carboxypeptidase H and a heat-shock protein of 65 kD. The identity of the antigen recognized by islet-cell antibodies, the most frequently used marker for type-I diabetes mellitus, remains a subject of discussion.