Treatment, Research, and Prevention of Type I Diabetes

Question 1

Recall the stages of T1D.

Answer 1

Question 2

Recall the risk stratification by T1D family history and HLA genotype

Answer 2

Question 3

____________________ have a realtively samll contribution to genetic risk of T1D.

Answer 3

Question 4

Recall the development of islet autoantibodies for T1D.

Answer 4

Question 5

Which proteins are specific for T1D autoantibodies?

Answer 5

Question 6

Recall T1D risk prediction by combining autoantibodies & HLA genotype

Answer 6

Question 7

Why do we need more biomarkers for disease risk?

Answer 7

• To prevent type 1 diabetes, need to be able to predict which individuals will develop the disease before Stage 1
  
  • <30% of individuals who have a single islet autoantibody progress to clinical disease.
  • Need to identify additional “biomarkers” that will increase the accuracy of predicting who will develop type 1 diabetes (and when clinical symptoms may begin).

Question 8

Recall other potential biomarkers for type 1 diabetes

Answer 8

• Past or ongoing research using samples from at-risk or recently diagnosed individuals:
  
  • Transcript analysis of whole blood samples or peripheral blood mononuclear cells
  • Responses in a standardized reporter cell line exposed to serum
  • Metabolomic analysis of serum
• New ‘biomarkers’ from these studies have yet to be definitively identified and replicated in independent patient cohorts.

Question 9

“More than any other common autoimmune disease, childhood and early adult T1D is now partially predictable in genetically susceptible individuals by careful use and analysis of ______ and ____________ biomarkers.”

Answer 9

“More than any other common autoimmune disease, childhood and early adult T1D is now partially predictable in genetically susceptible individuals by careful use and analysis of genetic and immunological biomarkers.”

Question 10

Recall heterogeneity in the clinical course of type 1 diabetes.

Answer 10

Question 11

Recall the various clinical presentations of T1D.

Answer 11

Question 12

Recall methods in diagnosing T1D.

Answer 12

Question 13

Recall the only current treatment for T1D.

Answer 13

Question 14

Recall the different types of insulin.

Answer 14

Question 15

How to measure how well the patient is controlling their glucose levels?

Answer 15

Question 16

Recall the limitations of studying T1D in humans.

Answer 16

Question 17

Recall natural history of type 1 diabetes in NOD mice.

Answer 17

Question 18

Recall the beta chain position 57 for Human and Mouse MHC II molecules.

Answer 18

Question 19

Recall the effect of the change of amino acid in position 57 of the MHC II molecule.

Answer 19

Question 20

Recall the role of temperature in incidence of T1D.

Answer 20

Question 21

Recall the role of microbial pathogens in the incidence of T1D.

Answer 21

Question 22

Recall how gut microbiota can affect development of T1D

Answer 22

Question 23

_________________ can be detected in peripheral blood & precede T1D in NOD mice

Answer 23

Insulin autoantibodies can be detected in peripheral blood & precede T1D in NOD mice

Question 24

NOD mice exhibit more extensive ___________ than human with type 1 diabetes

Answer 24

NOD mice exhibit more extensive insulitis than human with type 1 diabetes

Question 25

Recall how autoreactive CD8+ T cells recognize and kill beta cells in NOD mice

Answer 25

Question 26

Recall the effect of the loss of performing genes on NOD mice.

Answer 26

Question 27

Recall immunological abnormalities in NOD mice and its contribution to T1D pathogenesis.

Answer 27

Question 28

Recall the effect of depleting immune cells in NOD mice and its effect of T1D.

Answer 28

Question 29

Differ between T1D in NOD mice and humans.

Answer 29

Question 30

Recall the natural history for the development of type 1 diabetes in Sally

Answer 30

Question 31

Recall the disadvantages of current forms of insulin treatment.

Answer 31

Question 32

Recall the pro and cons of intensive insulin treatment.

Answer 32

Question 33

Recall limitations of artificial pancreas

Answer 33

Question 34

Recall the ultimate goal for T1D cure.

Answer 34

Question 35

Describe cell therapy for T1D.

Answer 35

Question 36

Recall Pancreatic islet isolation and transplantation procedure

Answer 36

Question 37

Describe the induction and maintenance of immunosuppression in islet allotransplantation.

Answer 37

Question 38

Recall the pros and cons of pancreatic islet transplantation.

Answer 38

Question 39

Recall Future sources of islets & beta cells for transplantation

Answer 39

Question 40

Recall the reasoning behind using the pig as a source of islet and beta cells.

Answer 40

Question 41

Recall methods in preventing rejection of pig organs.

Answer 41

Question 42

Recall other sources of beta cells.

Answer 42

Question 43

Recall the limitations and safety of Stem cell-derived insulin-producing cells.

Answer 43

Question 44

How to protect beta cells from immune responses or recipient from transplanted cells?

Answer 44

Question 45

Recall encapsulation requirements.

Answer 45

Question 46

Recall the major considerations for beta cell replacement as a cure for T1D

Answer 46

Question 47

Recall the following diagram of T1D prevention and treatment.

Answer 47

Question 48

Recall the Requirements for immune-based therapy for T1D.

Answer 48

Question 49

Describe the mechanism of the Teplizumab response.

Answer 49