Immunologic aspects of type I diabetes

Accumulating evidence supports the theory of an immunologic component in type I diabetes. The serum islet cell antibodies, the increased number of Ia-positive T cells in the peripheral blood of some new-onset patients, the presence of inflammatory cells in the islets and the apparent response of patients with new-onset diabetes to immunosuppressant medications all lead to this conclusion. However, it is still unknown if the immunologic aspects of the disease are primary or secondary phenomena. This question aside, it will be necessary to understand the immunologic factors if transplantation is to be successful as a permanent cure. If these factors are not understood and controlled, they will likely again result in destruction of the newly transplanted islet tissue. It is also probable that an understanding of the ongoing immunologic damage in the prediabetic stage will be necessary if diabetes is to be prevented. Clearly, much more research related to the immunologic aspects of type I diabetes is needed.