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Current Diabetes Reports
Published in: Current Diabetes Reports 11/2018

01-11-2018 | Pathogenesis of Type 1 Diabetes (A Pugliese and SJ Richardson, Section Editors)

The Effect of Age on the Progression and Severity of Type 1 Diabetes: Potential Effects on Disease Mechanisms

Authors: Pia Leete, Roberto Mallone, Sarah J. Richardson, Jay M. Sosenko, Maria J. Redondo, Carmella Evans-Molina

Published in: Current Diabetes Reports | Issue 11/2018

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Abstract

Purpose of Review

To explore the impact of age on type 1 diabetes (T1D) pathogenesis.

Recent Findings

Children progress more rapidly from autoantibody positivity to T1D and have lower C-peptide levels compared to adults. In histological analysis of post-mortem pancreata, younger age of diagnosis is associated with reduced numbers of insulin containing islets and a hyper-immune CD20hi infiltrate. Moreover compared to adults, children exhibit decreased immune regulatory function and increased engagement and trafficking of autoreactive CD8+ T cells, and age-related differences in β cell vulnerability may also contribute to the more aggressive immune phenotype observed in children. To account for some of these differences, HLA and non-HLA genetic loci that influence multiple disease characteristics, including age of onset, are being increasingly characterized.

Summary

The exception of T1D as an autoimmune disease more prevalent in children than adults results from a combination of immune, metabolic, and genetic factors. Age-related differences in T1D pathology have important implications for better tailoring of immunotherapies.
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Metadata
Title
The Effect of Age on the Progression and Severity of Type 1 Diabetes: Potential Effects on Disease Mechanisms
Authors
Pia Leete
Roberto Mallone
Sarah J. Richardson
Jay M. Sosenko
Maria J. Redondo
Carmella Evans-Molina
Publication date
01-11-2018
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 11/2018
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-018-1083-4

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