Molecular pathology of insulin-dependent diabetes mellitus (type I)

Since sufficiently long time the average life expectancy in IDDM did not change. Only new data concerning the causes and pathogenesis of the disease may improve such set-back. The most promising field of creating the better insight into etiology of IDDM are molecular pathological studies. This review attempts to summarize the state of art in this area choosing the problems of clinical relevance. Many of them are controversial, disturbing the immunogenetic hypothesis of IDDM etiology, majority positively support this idea. 6 topics are critically discussed in respective sub-chapters: 1) genetic control of autoimmunization processes as pertinent to beta cells; 2) genesis, actions and clinical significance of various types of autoantibodies against autoantigens; 3) character of beta cell antigens; 4) suggested mechanism of beta cell destruction; 5) new idea of prediabetic state and 6) lessons from immunosuppressive therapeutical trials. Author brings the story of etiological mechanisms of IDDM up to date pointing that more direct and specific information is needed to be applicable in practice.