INSULIN-DEPENDENT DIABETES AND HUMAN-LEUKOCYTE ANTIGENS

The association of diabetes with HLA class I alleles in the early 1970 s and with HLA class II alleles in the late 1970s provided a crucial, though indirect, indication of the role of immune phenomena in the dev elopment of insulin-dependent diabetes mellitus (IDDM). Geno-typing of HLA alleles in the mid-1980s opened up a new era. The very precise de finition of susceptibility and protection alleles proved to be an impo rtant diagnostic factor in predicting IDDM and was also the first step towards an understanding of the role of class II antigen-presenting m olecules in the development of the autoimmune reaction responsible for the destruction of insulin-secreting cells and the subsequent onset o f diabetes. Animal models have been instrumental in studying the possi ble relations between the development of IDDM autoimmunity and the exp ression of particular major histocompatibility complex alleles on a mu ltigenic susceptibility background.