Type 1 diabetes mellitus: multifactors that confer susceptibility to the autoimmune pathogenesis

Aims: To review the literature data concerning the factors which confer susceptibilitiy to the autoimmune pathogenesis of type I diabetes mellitus. Source of data: Review of specific articles on the issue published in national and in-ternational databases (SCIELO, LILACS, PUBMED). Summary of the findings: The etiopathogenesis of type I diabetes mellitus is associated to immunoinflammatory, genetic, and environmental factors. In this review, we approach the role of humoral (autoantibodies) and cellular autoimmunity which culminate with the disfunction of insulin-producers beta-cells. The precocity of the presence of some autoantibodies such as anti-islet cell antibodies, anti-insulin and anti-GAD65 are important characteristics of this pathology. The diverse genetic factors related to development of type 1 diabetes mellitus, mostly those linked to the human leucocyte antigen system, surely increment the apresentation of islet antigens to the immune system. Lastly, environmental factors, such as viral exposure, also contribute to the break of immunological tolerance observed in these patients. Conclusions: Type 1 diabetes mellitus has a highly complex etiopathogenesis. A variety of genetic and environmental factors potentialize the mechanisms of humoral and cellular autoimmunity which generate insulitis. The risk of severe hypoglicemia usually seen with insulin therapy and the chronic complications related to type 1 diabetes mellitus justify continuous research on the etiopathogenesis of this entity, so providing new therapeutic strategies.