Different Endotypes May Influence Type 1 Diabetes Development

(HealthDay News) — Type 1 diabetes development may arise from different immunopathological processes, research published in Diabetes suggests.

Sefina Arif, PhD, of the King’s College London School of Medicine, and colleagues performed immunologic analysis of autoantibodies and autoreactive T-cell responses in blood from 33 children and adolescents newly diagnosed with type 1 diabetes. In addition, they performed immunohistological analysis of postmortem samples of islet tissue from 21 children and adolescents with recently diagnosed type 1 diabetes

The researchers explored evidence for different immunological phenotypes indicating disease heterogeneity in type 1 diabetes.

In blood analysis for the first cohort, the researchers observed two equal-sized patient agglomerations, characterized by pro-inflammatory (interferon-gamma+, multi-autoantibody-positive) and partially-regulated (interleukin-10+, pauci-autoantibody-positive) responses. Similar clustering was observed in multi-autoantibody-positive siblings without diabetes at high risk for disease progression. 

Analysis of pancreatic tissue in the second cohort showed two types of insulitic lesion that differed by degree of cellular infiltrate and presence of B lymphocytes. Each subject had only one infiltration phenotype.

“These data indicate potentially related islet and blood autoimmune response phenotypes that coincide with, and precede disease,” the researchers wrote. “We conclude that different immunopathological processes (endotypes) may underlie type 1 diabetes, carrying important implications for treatment/prevention strategies.”


  1. Arif S et al. Diabetes. 2014;doi:10.2337/db14-0365.

This article originally appeared on Clinical Advisor