frontiersin.org
Footprints of Immune Cells in the Type 1 Diabetic Pancreas
Tissue residency and transit of both innate and adaptive immune cells are part of the physiological developmental program of multiple organs. In health, these cells function to remove cellular debris, remodel tissue architecture through growth and development, and surveil against opportunistic and chronic pathogens. However, these programs breakdown in tissue-specific autoimmune diseases, including in Type 1 Diabetes (T1D), in which the pancreatic insulin-producing beta cells are destroyed by the immune system. Traditionally, islet inflammation (insulitis) has been the histological hallmark of T1D. After careful examination of human pancreas samples collected over the last 50 years, it is now apparent that insulitis is frequently present near T1D onset, but its detection dramatically decreases over time. Moreover, emerging studies now support a generalized pancreatic mass defect and additional abnormalities and cellular infiltration within the acinar tissues surrounding the islets of Langerhans. However, little is known about the phenotype of the infiltrating cells, their antigen specificity, and how they recirculate to lymph nodes, blood and vice-versa. Innate immune cells like macrophages and neutrophils are likely to be present in early stages of the disease, potentially initiating inflammation and regulating lymphocyte entry into the islet. Tissue-resident CD8+ T cells can be found in non-diabetic pancreas but their numbers are increased in recent-onset T1D subjects, a...