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Identifying the ‘Achilles heel’ of type 1 diabetes

Battaglia, M., Buckner, J. H., Levings, M. K., Richardson, S. J., Wong, F. S. 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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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: 01 Feb 2022 14:30

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