Mouse and man: multiple genes and multiple autoantigens in the aetiology of type I DM and related autoimmune disorders.

Autoimmunity to the pancreatic beta cell appears to be a chronic disorder which in some individuals progresses to overt type I diabetes [1]. Studies of offspring or siblings of patients with type I diabetes (IDDM) and discordant twins who have been followed for over 30 years are shedding new light on the disorder. Recent advances in molecular biological techniques have resulted in our ability to identify novel autoantigens and rapidly develop sensitive and specific tests to detect beta cell autoimmunity. The ability to cost-effectively screen the general population for diabetes susceptibility is rapidly becoming a reality. Animal models of diabetes such as the non-obese diabetes (NOD) mouse have provided insights into both pathogenesis of this disease and potentially into the prevention of diabetes as well. We will attempt to use our knowledge gained from studies of man and the NOD mouse to illustrate what we know and need to learn in order to prevent type I diabetes.