Autoimmunity And The Pathogenesis Of Diabetes (endocrinology And Metabolism)

It has been a challenge for us to edit this volume of Endocrinology and Metabo­ lism: Progress in Research and Clinical Practice. The topic of the pathogenesis of insulin-dependent, type I diabetes mellitus is particularly appropriate for this series, since advances in this area have been made, to a large extent, by applying state-of-the-art laboratory techniques to clinical samples. Over the last several years, a number of lines of evidence have been gathered, suggesting that classic type I diabetes mellitus results from the autoimmune des­ truction of pancreatic beta-cells in genetically susceptible individuals. This hypothesis is particularly appealing because it offers a rational approach to the prevention of diabetes by immunosuppression. We have tried to present a balanced, authoritative summary of the information currently available to support the autoimmune hypothesis for the pathogenesis of human type I diabetes, to place this information in historical perspective, to include relevant information from animal models of type I diabetes in which more invasive experimentation is ethical, and, finally, to update the reader on the current status of attempts to intervene in the progression of diabetes with immunosuppressive drugs. New York, New York Fredda Ginsberg-Fellner Robert C. McEvoy Contents Preface.. . . .. .. .. . . . . . . . . . . . . ... . . . . . . . . . . . .. . . . . . . .. . . . . v Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Xl . . . . . . . . . . . . . 1. The Autoimmune Hypothesis of Insulin-Dependent Diabetes: 1965 to the Present . . . . . . . . . . . . ..................... . . . . . . Front Matter....Pages i-xii The Autoimmune Hypothesis of Insulin-Dependent Diabetes: 1965 to the Present....Pages 1-28 Immunogenetics and the Pathogenesis of Insulin-Dependent Diabetes Mellitus....Pages 29-55 Association of Insulin-Dependent Diabetes Mellitus and Other Autoimmune Diseases....Pages 56-67 The Humoral Anti-Islet Immune Response: Cytoplasmic Islet-Cell Antibodies: Technical Aspects and Clinical Applications....Pages 68-86 The Humoral Anti-Islet Response: Biochemical Characterization....Pages 87-104 The Humoral Anti-Islet Immune Response: Immunochemical Studies of Glycoconjugate Antigens....Pages 105-146 Insulin Autoantibodies....Pages 147-164 Cell-Mediated Anti-Islet—Cell Immune Response: Clinical Experience and Lessons from Animal Models....Pages 165-183 The Pathogenesis of Immunologically Mediated Diabetes....Pages 184-205 Viral Pathogenesis of Insulin-Dependent Diabetes Mellitus....Pages 206-255 Immune Intervention in Diabetes: State of the Art and Future Directions....Pages 256-281 Back Matter....Pages 283-296