Prevention of autoimmune disease: The type 1 diabetes paradigm

Abstract

Prevention of autoimmune disease based on a mechanistic understanding of pathogenesis will be the ultimate triumph of immunological good over evil. Identifying high-risk individuals before or soon after the onset of pathology and accurately predicting subsequent clinical disease is a prerequisite for prevention. For this reason alone, type 1 diabetes (T1D) is arguably the paradigm for autoimmune disease prevention. Autoimmunity against pancreatic islet insulin-producing beta cells in T1D is associated with specific human leukocyte antigen (HLA) haplotypes that denote high genetic risk, a basis for primary prevention. The majority of children and young adults who will develop T1D can be ident..