Seminars in Immunopathology

, Volume 33, Issue 1, pp 9-21

First online:

Immunopathology of the human pancreas in type-I diabetes

  • Sarah J. RichardsonAffiliated withPeninsula Medical School, University of PlymouthInstitute of Biomedical and Clinical Sciences, Peninsula Medical School Email author 
  • , Abby WillcoxAffiliated withPeninsula Medical School, University of Exeter
  • , Adrian J. BoneAffiliated withSchool of Pharmacy and Biomolecular Sciences, University of Brighton
  • , Noel G. MorganAffiliated withPeninsula Medical School, University of Exeter
  • , Alan K. FoulisAffiliated withDepartment of Pathology, Royal Infirmary

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Type 1 diabetes is a chronic autoimmune disease characterised by the selective destruction of pancreatic beta (β) cells. The understanding of the aetiology of this disease has increased dramatically in recent years by the study of tissue recovered from patients, from analysis of the responses of isolated islet and β-cells in tissue culture and via the use of animal models. However, knowledge of the immunopathology of type 1 diabetes in humans is still relatively deficient due largely to the difficulty of accessing appropriate samples. Here we review the state of current knowledge in relation to the histopathological features of the disease in humans. We focus specifically on recent-onset type 1 diabetes cases since in such patients, evidence of the ongoing disease process is still present. We chart the progression of the disease by describing the characteristic features of the pancreas, consider the sequence of immune cell infiltration and discuss the abnormalities of MHC antigen expression. The possibility that these changes might derive from a persistent enteroviral infection of the islet beta cells is examined.


Insulitis Beta-cell death Enterovirus Recent-onset type 1 diabetes MHC Chemokine Pancreatic histology