Figure 1.

Type 1 diabetes (T1D) pathogenesis. Cellular events associated with driving T cell-mediated T1D are depicted within the pancreatic lymph node (PLN) and pancreas. Upon initiation of β cell autoimmunity via an ill-defined event, dendritic cells (DC) migrate from the pancreas ferrying islet autoantigens into the PLN. Here, naïve β cell-specific CD4⁺ and CD8⁺ T cells are activated and differentiate into distinct Teff subsets associated with T1D progression including CD8⁺ Tc1, CD4⁺ Th1, Th17, and Tfh. Early indication of ongoing autoimmunity is marked by the detection islet-specific autoantibodies (AutoAbs). Teff traffic into the pancreas and initiate β cell damage, which gradually increases over time prompting nominal insulin production.