Setting the Stage for Islet Autoimmunity in Type 2 Diabetes: Obesity-Associated Chronic Systemic Inflammation and Endoplasmic Reticulum (ER) Stress
Abstract
Islet autoimmunity has been identified as a component of both type 1 (T1D) and type 2 (T2D) diabetes, but the pathway through which islet autoimmunity develops in T1D and T2D may be different. Acknowledging the presence of islet autoimmunity in the pathophysiology of T2D, a historically nonautoimmune metabolic disease, would pave the way for important changes in classifications of and therapeutic options for T2D. In order to fully appreciate the importance of islet autoimmunity in T2D, the underlying mechanisms for immune system activation need to be explored. In this review, we focus on the potential origin of immune system activation (innate and adaptive) leading to the development of islet autoimmunity in T2D.
- Received March 14, 2019.
- Accepted September 1, 2019.
- © 2019 by the American Diabetes Association.
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- Article
- Abstract
- Introduction
- Islet Autoimmunity in T2D
- Neoantigen Availability: Creating Self-Reactivity?
- ER Stress and Diabetes
- Islet Inflammation and Diabetes
- Potential Sites of Initiation: Intestinal Immune System and Gut Microbiome
- Dysbiosis, Changes in Gut Microbial Populations, and Insulin Resistance
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