Immune Responses in Type 1 Diabetes

A special issue of Biomolecules (ISSN 2218-273X). This special issue belongs to the section "Molecular Biology".

Deadline for manuscript submissions: closed (28 February 2026) | Viewed by 17850

Special Issue Editors


E-Mail Website
Guest Editor
Translational Research Program, Benaroya Research Institute, Seattle, WA 98101, USA
Interests: human type 1 diabetes; autoimmunity; T cell immunity; target tissue

E-Mail Website
Guest Editor
Department of Medicine, UMass Chan Medical School, Worcester, MA 01605, USA
Interests: human type 1 diabetes; autoimmunity; T cell responses

Special Issue Information

Dear Colleagues,

Type 1 diabetes (T1D) represents an archetypical polygenic autoimmune disease that renders patients insulin-dependent through the depletion of functional pancreatic beta cells via a combination of direct killing, apoptosis, and cellular dysfunction. The management of the disease requires a precisely administered insulin regimen to avoid ketoacidosis due to acute, severe hyperglycemia and long-term complications due to the accumulated effects of glucose excursions while avoiding hypoglycemia. The risk for the development of T1D can be predicted through the occurrence of biochemically defined islet autoantibodies. Furthermore, the genetic risk for the disease is dominated by the HLA class II locus, along with HLA class I and a broad number of immune response-related genes with more modest effect sizes. Early histological studies and more recent and elegant studies of human pancreatic tissue from organ donors have consistently revealed the HLA class I expression and document infiltration of the islets by multiple types of immune cells, including CD8+ and CD4+ T cells, gamma delta T cells, myeloid cells, NK cells, B cells, and CD11c+ antigen presenting cells. The role that these varied immune cell populations play in the disease process remains an important area of active investigation. In spite of the recent efforts, only limited information exists regarding the antigen and epitope specificity of islet-infiltrating T cells, but the existing literature confirms the presence of both autoreactive and bystander T cells. Accumulating studies also support the existence of an ongoing dialog between immune cells and pancreatic beta cells, which may include both disease-promoting and disease-restraining effects. Exploring this complex landscape offers the opportunity to unravel underlying causes of disease, sources of heterogeneity, and avenues for effective intervention.

Therefore, the goal of this Special Issue, entitled “Immune Responses in Type 1 Diabetes", is to provide a broad overview of the contribution of various immune cell subsets to disease development and etiology, including knowledge gained through the study of human subjects and animal models of the disease. This Special Issue aims to provide insights about the dialog between immune cells and pancreatic islets, including mechanisms that promote or restrain diabetes progression. Original research using conventional (e.g., immunohistochemistry, cell culture, flow cytometry) and more advanced methods of tissue and cellular characterization (e.g., scRNA-Seq and scATAC-Seq) are invited, as are well-balanced review articles. We welcome your contributions to this important Special Issue.

Dr. Eddie A. James
Dr. Sally C. Kent
Guest Editors

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Keywords

  • type 1 diabetes
  • insulitis
  • immune response

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Published Papers (7 papers)

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Research

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18 pages, 6799 KB  
Article
Differential Contributions of IgM and IgG Autoantibodies to Serologic IA2 Reactivity in Type 1 Diabetes
by Xuming Mao, Jake Konigsberg, Nadia Noorchashm, Wenzhao Meng, James J. Knox, Gregory J. Golden, Jacob T. Hamilton, Tara K. Maxwell, Chengyang Liu, Michael R. Betts, Steven M. Willi, Ali Naji, Patrick Hanley and Eline T. Luning Prak
Biomolecules 2026, 16(4), 500; https://doi.org/10.3390/biom16040500 - 26 Mar 2026
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Abstract
Autoantibodies targeting islet antigen 2 (IA2) are critical diagnostic and prognostic markers for type 1 diabetes (T1D). Standard clinical assays do not differentiate between IgG and IgM isotypes, yet these antibodies have distinct roles in the T1D autoimmunity. We therefore adapted electrochemiluminescence (ECL) [...] Read more.
Autoantibodies targeting islet antigen 2 (IA2) are critical diagnostic and prognostic markers for type 1 diabetes (T1D). Standard clinical assays do not differentiate between IgG and IgM isotypes, yet these antibodies have distinct roles in the T1D autoimmunity. We therefore adapted electrochemiluminescence (ECL) assays to separately detect IgG and IgM antibodies against the IA2 intracellular domain (AA601-979). Assay specificity was confirmed by indirect immunofluorescence, which showed autoantibody binding to IA2-overexpressing cells. Plasma samples were analyzed from two independent cohorts: organ donors of the Human Pancreas Analysis Program (HPAP, n = 69) and children from a Janssen–Breakthrough T1D-funded study (n = 65). Diabetics had significantly higher levels of IA2 IgG (p < 0.001) but not IgM (p > 0.05) compared with controls. Notably, IgM and IgG IA2 antibody levels were not correlated. However, IgM modulates IgG detection: IgM depletion increased detected IgG levels to IA2 in some donors, and sera from donors with high IA2-specific IgM levels reduced monoclonal IgG anti-IA2 antibody binding to IA2. Purified IgM from healthy individuals also suppressed monoclonal IgG binding. These findings support distinct, non-redundant roles for IA2-specific IgG and IgM in T1D serology. Isotype-specific autoantibody analysis may improve risk stratification and monitoring of T1D individuals receiving immunomodulatory therapies. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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Review

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14 pages, 569 KB  
Review
Type I Interferons as Contextual Regulators of B-Cell Tolerance in Type 1 Diabetes
by Mebrahtu G. Tedla and Jamie L. Felton
Biomolecules 2026, 16(4), 563; https://doi.org/10.3390/biom16040563 - 10 Apr 2026
Viewed by 481
Abstract
Type 1 diabetes (T1D) is an immune-mediated disease characterized by progressive autoimmune destruction of pancreatic β cells. Although traditionally viewed as primarily T-cell-driven, B cells play essential roles in disease pathogenesis. In addition to producing islet autoantibodies, B cells contribute to immune activation [...] Read more.
Type 1 diabetes (T1D) is an immune-mediated disease characterized by progressive autoimmune destruction of pancreatic β cells. Although traditionally viewed as primarily T-cell-driven, B cells play essential roles in disease pathogenesis. In addition to producing islet autoantibodies, B cells contribute to immune activation through antigen presentation and cytokine secretion, thereby shaping autoreactive T-cell responses. The earliest clinical predictor of T1D is the appearance of islet autoantibodies in the blood, reflecting a breach in B-cell tolerance well before symptomatic disease onset. In individuals at high genetic risk, type I interferon (IFN) signatures are detectable in peripheral blood prior to seroconversion, suggesting that type I IFNs may act as upstream regulators of B-cell tolerance. Peripheral tolerance is enforced through layered checkpoints including transitional selection, maintenance of anergy, germinal center regulation, and regulatory B-cell differentiation. Studies in systemic autoimmunity demonstrate that type I IFN signaling lowers B-cell activation thresholds, enhances BCR and TLR responsiveness, promotes survival of autoreactive transitional clones via BAFF induction, destabilizes anergy, and skews differentiation toward inflammatory phenotypes such as T-bet+ age-associated B cells. Consistent with this model, single-cell transcriptomic and BCR repertoire analyses in T1D reveal clonal expansion and proinflammatory signatures in islet-reactive B cells during the preclinical stage. Together, these findings implicate the IFN–B-cell axis as a potential target for early disease modification. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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20 pages, 5876 KB  
Review
Molecular Portrait of Autoantigens in Type 1 Diabetes
by Ilya Kandinov, Anastasia Knyazeva, Elizaveta Lander, Dmitry Gryadunov and Elena Savvateeva
Biomolecules 2025, 15(12), 1723; https://doi.org/10.3390/biom15121723 - 11 Dec 2025
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Abstract
This review focuses on the molecular pathogenesis of Type 1 diabetes (T1D), specifically on the key autoantigens targeted by the autoimmune response and the clinical implications of their epitope specificity. T1D is characterized by the destruction of insulin-producing pancreatic β-cells. The autoimmune attack [...] Read more.
This review focuses on the molecular pathogenesis of Type 1 diabetes (T1D), specifically on the key autoantigens targeted by the autoimmune response and the clinical implications of their epitope specificity. T1D is characterized by the destruction of insulin-producing pancreatic β-cells. The autoimmune attack is directed against a defined set of autoantigens, primarily insulin, glutamic acid decarboxylase 65, tyrosine phosphatase-like protein, zinc transporter 8, as well as several minor autoantigens. A critical advancement in understanding the disease has been the analysis of epitope specificity, revealing that immunodominant epitopes are conformational and often localized to C-terminal protein regions, exposed during β-cell degradation. The introduction of sensitive multiplex assays for the simultaneous detection of T1D-associated autoantibodies represents a major diagnostic breakthrough. These platforms enable early diagnosis, risk stratification, and the identification of a “therapeutic window” for intervention. At this preclinical stage, antigen-specific immunotherapies aimed at restoring immune tolerance show significant promise. Ultimately, the combination of personalized diagnostic profiles, epitope mapping, and targeted therapies forms the basis for a new T1D management paradigm focused on halting the autoimmune process itself and preserving functional β-cell mass. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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22 pages, 1369 KB  
Review
Neutrophils in Type 1 Diabetes: Untangling the Intricate Web of Pathways and Hypothesis
by Laura Nigi, Erika Pedace, Francesco Dotta and Guido Sebastiani
Biomolecules 2025, 15(4), 505; https://doi.org/10.3390/biom15040505 - 31 Mar 2025
Cited by 5 | Viewed by 3154
Abstract
Neutrophils are increasingly recognized as key contributors to the pathogenesis of Type 1 Diabetes (T1D), yet their precise mechanistic role in disease onset and progression remains incompletely understood. While these innate immune cells reside in pancreatic tissue and support tissue homeostasis under physiological [...] Read more.
Neutrophils are increasingly recognized as key contributors to the pathogenesis of Type 1 Diabetes (T1D), yet their precise mechanistic role in disease onset and progression remains incompletely understood. While these innate immune cells reside in pancreatic tissue and support tissue homeostasis under physiological conditions, they can also drive tissue damage by triggering innate immune responses and modulating inflammation. Within the inflammatory milieu, neutrophils establish complex, bidirectional interactions with various immune cells, including macrophages, dendritic cells, natural killer cells, and lymphocytes. Once activated, they may enhance the innate immune response through direct or indirect crosstalk with immune cells, antigen presentation, and β-cell destruction or dysfunction. These mechanisms underscore the multifaceted and dynamic role of neutrophils in T1D, shaped by their intricate immunological interactions. Further research into the diverse functional capabilities of neutrophils is crucial for uncovering novel aspects of their involvement in T1D, potentially revealing new therapeutic targets to modulate disease progression. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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16 pages, 3824 KB  
Review
Tissue Resident and Infiltrating Immune Cells: Their Influence on the Demise of Beta Cells in Type 1 Diabetes
by Sophie L. Walker, Pia Leete and Joanne Boldison
Biomolecules 2025, 15(3), 441; https://doi.org/10.3390/biom15030441 - 19 Mar 2025
Cited by 3 | Viewed by 3351
Abstract
Type 1 diabetes (T1D) is an organ-specific autoimmune disease that results in the selective loss of pancreatic beta cells and an eventual deficit in insulin production to maintain glucose homeostasis. It is now increasingly accepted that this dynamic disease process is multifactorial; involves [...] Read more.
Type 1 diabetes (T1D) is an organ-specific autoimmune disease that results in the selective loss of pancreatic beta cells and an eventual deficit in insulin production to maintain glucose homeostasis. It is now increasingly accepted that this dynamic disease process is multifactorial; involves a variety of immune cells which contribute to an inflamed pancreatic microenvironment; and that the condition is heterogenous, resulting in variable rates of subsequent beta cell damage. In this review, we will explore the current understanding of the cellular interactions between both resident and infiltrating immune cells within the pancreatic environment, highlighting key mechanisms which may promote the beta cell destruction and islet damage associated with T1D. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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11 pages, 340 KB  
Review
Current and Emerging Assays for Measuring Human T-Cell Responses Against Beta-Cell Antigens in Type 1 Diabetes
by Ting-Chen Lin, Matthew Lacorcia and Stuart I. Mannering
Biomolecules 2025, 15(3), 384; https://doi.org/10.3390/biom15030384 - 6 Mar 2025
Cited by 1 | Viewed by 2365
Abstract
Type 1 diabetes (T1D) is an autoimmune disease caused by T-cell mediated destruction of the pancreatic insulin-producing beta cells. Currently, the development of autoantibodies is the only measure of beta-cell autoimmunity used in the clinic. Despite T-cells’ well-accepted role in the autoimmune pathogenesis [...] Read more.
Type 1 diabetes (T1D) is an autoimmune disease caused by T-cell mediated destruction of the pancreatic insulin-producing beta cells. Currently, the development of autoantibodies is the only measure of beta-cell autoimmunity used in the clinic. Despite T-cells’ well-accepted role in the autoimmune pathogenesis of human T1D, autoimmune T-cell responses against beta cells remain very difficult to measure. An assay capable of measuring beta-cell antigen-specific T-cell responses has been a long-sought goal. Such an assay would facilitate the direct monitoring of T1D-associated T-cell responses facilitating, earlier diagnosis and rapid evaluation of candidate immune therapies in clinical trials. In addition, a simple and robust assay for beta-cell antigen-specific T-cell responses would be a powerful tool for dissecting the autoimmune pathogenesis of human T1D. Here, we review the challenges associated with measuring beta-cell antigen-specific T-cell responses, the current assays which are used to achieve this and, finally, we discuss BASTA, a promising emerging assay for measuring human beta-cell antigen-specific CD4+ T-cell responses. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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18 pages, 2516 KB  
Review
Dia-B-Ties: B Cells in the Islet–Immune-Cell Interface in T1D
by Brandon K. Hilliard, Jessica E. Prendergast and Mia J. Smith
Biomolecules 2025, 15(3), 332; https://doi.org/10.3390/biom15030332 - 25 Feb 2025
Cited by 2 | Viewed by 4771
Abstract
Type 1 diabetes (T1D) is an autoimmune disease that affects an estimated 30 million people worldwide and results in a lifelong dependency of exogenous insulin treatments. While T1D is characterized by T-cell driven-destruction of the insulin-secreting β cells, B lymphocytes play a key [...] Read more.
Type 1 diabetes (T1D) is an autoimmune disease that affects an estimated 30 million people worldwide and results in a lifelong dependency of exogenous insulin treatments. While T1D is characterized by T-cell driven-destruction of the insulin-secreting β cells, B lymphocytes play a key role in the islet–immune interface. B cells are an essential intermediary between islet cells and other immune-cell populations. Through antigen presentation, cytokine secretion, and antibody production, B cells play a role in activating autoreactive islet-specific T cells, thus potentiating pancreatic inflammation in the early stages of T1D. Despite this, their role in disease development remains an understudied feature of T1D with significant therapeutic potential. Herein, we will discuss the current knowledge of the islet–immune-cell interface within T1D through the lens of B lymphocytes. We will also consider knowledge gaps that may be limiting further therapeutic opportunities. Full article
(This article belongs to the Special Issue Immune Responses in Type 1 Diabetes)
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