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The Role of Environmental Factors in Modulating Insulin Dependent Diabetes

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The Role of Micro-organisms in Non-infectious Diseases

Part of the book series: Argenteuil Symposia ((ARGENTEUIL))

Abstract

Considerable evidence indicates that insulin dependent diabetes mellitus (IDDM) has an autoimmune aetiology [1]. This evidence includes the frequent detection of islet cell surface and cytoplasmic autoantibodies in the prodromal period, as well as IDDM occurrence in patients with polyendocrine autoimmune disorders such as systemic lupus erythematosus, Hashimoto’s thyroiditis, and Graves’ disease. Perhaps the most compelling evidence for the autoimmune nature of IDDM in humans has been the fate of segmental pancreatic grafts transplanted from a normal sib into a monozygotic twin with IDDM of long duration. In the absence of immunosuppression, only a transient amelioration of hyperglycaemia was observed with islets in the graft developing insulitis and selective destruction of the islet β cells within 2 months [2]. The strongest genetic susceptibility modifiers are tightly linked to the HLA-DR and DQ loci, and could, in fact, represent one or more of these genes themselves [3,4]. Concordance rates as high as 54% in monozygotic twins have confirmed the importance of genetic factors in aetiopathogenesis of IDDM, but the lack of 100% concordance suggests that environmental factors (pathogenic micro-organisms and viruses, toxins or additives in the diet) may modify penetrance of diabetes susceptibility genes [5]. The contribution of environmental factors in modulating the penetrance of susceptibility genes has remained unresolved, and indeed has been the subject of some controversy [6]. Monozygotic twins represent the classic system for evaluating the interplay between heredity and environment in the aetiopathogenesis of human constitutive disorders.

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Authors
  1. E. H. Leiter
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Editors and Affiliations

  1. Department of Immunohaematology and Blood Bank, University Hospital, 2333 AA, Leiden, The Netherlands

    René R. P. de Vries  & Jon J. van Rood  & 

  2. Department of Cell Biology, The Weizmann Institute of Science, PO Box 26, 76 100, Rehovot, Israel

    Irun R. Cohen

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Leiter, E.H. (1990). The Role of Environmental Factors in Modulating Insulin Dependent Diabetes. In: de Vries, R.R.P., Cohen, I.R., van Rood, J.J. (eds) The Role of Micro-organisms in Non-infectious Diseases. Argenteuil Symposia. Springer, London. https://doi.org/10.1007/978-1-4471-1796-4_4

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  • DOI: https://doi.org/10.1007/978-1-4471-1796-4_4

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  • Online ISBN: 978-1-4471-1796-4

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