Autoimmune Inflammation and Insulin Resistance: Hallmarks So Far and Yet So Close to Explain Diabetes Endotypes.
Alessandra PetrelliAnna GiovenzanaVittoria InsalacoBrett E PhillipsMassimo PietropaoloNick GiannoukakisPublished in: Current diabetes reports (2021)
Recent evidence indicates that type 1 diabetes can be accompanied by insulin resistance and type 2 diabetes exhibits self-reactivity. These two previously unknown conditions can influence the progression and outcome of the disease. Unlike most conventional considerations, diabetes appears to consist of a spectrum of intermediate phenotypes that includes monogenic and polygenic loci linked to inflammatory processes including autoimmunity, beta cell impairment, and insulin resistance. Here we discuss why a shift of the classical bi-modal view of diabetes (autoimmune vs. non-autoimmune) is necessary in favor of a model of an immunological continuum of endotypes lying between the two extreme "insulin-resistant" and "autoimmune beta cell targeting," shaped by environmental and genetic factors which contribute to determine specific immune-conditioned outcomes.
Keyphrases
- type diabetes
- insulin resistance
- glycemic control
- multiple sclerosis
- high fat diet
- single cell
- cardiovascular disease
- adipose tissue
- oxidative stress
- metabolic syndrome
- polycystic ovary syndrome
- genome wide
- high fat diet induced
- drug induced
- skeletal muscle
- cancer therapy
- gene expression
- mesenchymal stem cells
- copy number
- risk assessment