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DIAbetes type 1 PRediction, Early Pathogenesis and Prevention

Coordinator: Ezio BONIFACIO
Project Number: 202013
EC contribution: € 5,999,200.00
Project website:

The earliest currently identifiable process in the pathogenesis of type 1 diabetes (T1D) is the development of autoimmunity to islet beta cells in the form of autoantibodies. Hindering attempts to prevent autoimmune T1D, the aetiology and pathogenesis of the islet auto-immunization, including whether it is preceded by metabolic abnormalities and cell-mediated autoimmunity, is still poorly understood. To overcome this, DIAPREPP will focus on the early auto-immunization against islet antigens, in particular to disclose events preceding current autoantibody markers. The concept is that events prior to auto-immunization govern the likelihood and ‘signature’ of immunization, which in turn determines progression to disease. The overall objective is to determine mechanisms of islet autoantigen immunization. In a truly collaborative manner, and through five S/T workpackages plus three dedicated to dissemination, training, and management, DIAPREPP will

  1. provide a unique set of clinical material that includes a case-control cohort representative of the world’s largest studies of pre-T1D, with follow-up and samples from birth, and pancreatic islets and lymph nodes from patients;
  2. investigate the effects of environmental exposure to infections on islet cells and immune cells;
  3. perform extensive metabolomic analysis of pre-autoimmune samples and in relevant animal models to test mechanistic hypotheses of auto-immunization;
  4. carry out detailed analyses of early autoimmune responses with a special focus on autoreactive CD8+ T cells; and
  5. apply findings to ongoing prevention studies.

The expected impact of DIAPREPP is new fundamental knowledge regarding how

  1. immunization against islet autoantigens can occur;
  2. signs of self-immunization can be exploited for prediction and monitoring of disease; and
  3. the immunization or its progression to islet beta cell destruction and T1D development can be prevented.

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