Identifying the ‘Achilles heel’ of type 1 diabetes

Battaglia, M., Buckner, J. H., Levings, M. K., Richardson, S. J., Wong, F. S. ORCID: https://orcid.org/0000-0002-2812-8845 and Tree, T. I. 2021. Identifying the ‘Achilles heel’ of type 1 diabetes. Clinical and Experimental Immunology 204 (2) , pp. 167-178. 10.1111/cei.13570

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Abstract

When Thetis dipped her son Achilles into the River Styx to make him immortal, she held him by the heel, which was not submerged, and thus created a weak spot that proved deadly for Achilles. Millennia later, Achilles heel is part of today's lexicon meaning an area of weakness or a vulnerable spot that causes failure. Also implied is that an Achilles heel is often missed, forgotten or under-appreciated until it is under attack, and then failure is fatal. Paris killed Achilles with an arrow ‘guided by the Gods’. Understanding the pathogenesis of type 1 diabetes (T1D) in order to direct therapy for prevention and treatment is a major goal of research into T1D. At the International Congress of the Immunology of Diabetes Society, 2018, five leading experts were asked to present the case for a particular cell/element that could represent ‘the Achilles heel of T1D’. These included neutrophils, B cells, CD8+ T cells, regulatory CD4+ T cells, and enteroviruses, all of which have been proposed to play an important role in the pathogenesis of type 1 diabetes. Did a single entity emerge as ‘the’ Achilles heel of T1D? The arguments are summarized here, to make this case.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Wiley
ISSN:	0009-9104
Date of First Compliant Deposit:	26 January 2022
Date of Acceptance:	18 November 2020
Last Modified:	10 Nov 2022 10:29
URI:	https://orca.cardiff.ac.uk/id/eprint/146966

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