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

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

Research output: Contribution to journalReview article

1 Citation (Scopus)

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.

Original languageEnglish (US)
Article number115
JournalCurrent Diabetes Reports
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2018

Fingerprint

Type 1 Diabetes Mellitus
Genetic Loci
C-Peptide
Age of Onset
Autoantibodies
Immunotherapy
Autoimmune Diseases
Pancreas
Insulin
Pathology
T-Lymphocytes
Phenotype

Keywords

  • Age
  • Autoimmunity
  • C-peptide
  • Type 1 diabetes
  • β cell

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

The Effect of Age on the Progression and Severity of Type 1 Diabetes : Potential Effects on Disease Mechanisms. / Leete, Pia; Mallone, Roberto; Richardson, Sarah J.; Sosenko, Jay M.; Redondo, Maria J.; Evans-Molina, Carmella.

In: Current Diabetes Reports, Vol. 18, No. 11, 115, 01.11.2018.

Research output: Contribution to journalReview article

Leete, Pia ; Mallone, Roberto ; Richardson, Sarah J. ; Sosenko, Jay M. ; Redondo, Maria J. ; Evans-Molina, Carmella. / The Effect of Age on the Progression and Severity of Type 1 Diabetes : Potential Effects on Disease Mechanisms. In: Current Diabetes Reports. 2018 ; Vol. 18, No. 11.
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