INTERACTION OF GENETIC AND ENVIRONMENTAL-FACTORS IN THE PATHOGENESIS OF INSULIN-DEPENDENT DIABETES-MELLITUS

The current concept of the pathogenesis of insulin-dependent diabetes mellitus (IDDM) is based on the view that environmental factors, eithe r alone or in combination, trigger in a genetically susceptible indivi dual an autoimmune process which leads to the destruction of the insul in-secreting beta cells. The identification of environmental risk fact ors for IDDM is of utmost importance with regard to possibilities for implementing preventive measures. Studies on the interaction between g enetic and environmental factors may be complicated by the observation s that genetic markers, e.g. HLA risk alleles, may vary from one popul ation to another, and combinations of predisposing genes may differ be tween populations. In addition, the role of a given environmental trig ger in initiating the autoimmune process may be variable in various in dividuals depending on the genetic set-up and other host-related chara cteristics. As prevention trials are already being initiated, and gene tic screening is essential in the identification of individuals at inc reased risk of IDDM, it is crucial to learn more about the interaction of genetic and environmental factors in this disease. Copyright (C) 1 997 Elsevier Science B.V.