Symposium 14: Environmental triggers

Abstract

Symposium 14: When does type 1 diabetes mellitus begin?

Environmental triggers

In recent years, type 1 diabetes has registered an increased incidence rate of 3-4% per year, mainly in children under five years of age. HLA represents the largest genetic contribution (50 % of the contribution) while the other half is caused by more than 50 non-HLA genetic polymorphisms. Even though 70% of cases carry risk HLA alleles, only 3-7% of children with these alleles develop T1D. This means that additional factors are necessary in order to trigger and develop the disease process in predisposed subjects. In recent decades, a sharp increase in the pressure of environmental contribution developing type 1 diabetes has been observed.  Identification and confirmation of environmental determinants remain a challenge. Probably, lifestyle factors that increase insulin demands by producing endoplasmic reticulum stress, promote the presence of post-translational modifications in endogenous B cell proteins, which generates the production of neoantigens, that is, hybrid insulin peptides that initiate and/or sustain autoimmunity.