Med. praxi. 2024;21(5):276-280 | DOI: 10.36290/med.2024.036

Type 1 diabetes mellitus imunopathogenesis - a view for clinical practice

prof. MUDr. Kateřina Štechová, Ph.D.

Interní klinika 2. LF UK a FN v Motole, Praha

Type 1 diabetes mellitus (DM1) is an autoimmune disease in which the insulin-producing β-cells of the pancreas are destroyed by the immune system. In the development of DM1, genetic predisposition plays a role, but also external factors contribute to the breaking of immunological tolerance. The importance of these factors is individual, which is reflected in the clinical heterogeneity of the diabetes clinical onset (different age at manifestation, speed of development of clinical symptoms, etc.). In DM1 patients various immunological abnormalities have been described, however, a key role is still attributed to autoreactive T lymphocytes. A common immunological feature of DM1 is also the production of autoantibodies, which, although they do not have a clear pathogenetic role, are a reliable and early marker of the progression of the process to overt diabetes (newly referred to as the third stage of DM1). The fact that the early diagnosis of diabetes is important for the further course of the disease (lower incidence of chronic microvascular complications, etc.), as well as the fact that a drug (teplizumab - a monoclonal antibody against the lymphocyte marker CD3) which slows down the progression of the process to the mentioned 3rd stage has already been launched in the United States of America, supports efforts to introduce population-wide screening for DM1 by examining diabetes-associated autoantibodies.

Keywords: autoimmunity, autoantibodies, type 1 diabetes mellitus, screening.

Received: August 12, 2024; Revised: September 6, 2024; Accepted: September 9, 2024; Published: December 2, 2024  Show citation