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Autoreactive CD8+ T cells in Type 1 diabetes: implications for pathogenesis, diagnosis, disease progression and therapeutic intervention

Joana RF Abreu & Bart O Roep

Type 1 diabetes is an autoimmune disease in which insulin-producing b cells are destroyed. CD8+ T cells have proven critical in this selective b‑cell destruction process. New therapeutic approaches to intervene in the immunopathogenesis of Type 1 diabetes are currently under development or are being assessed in the clinic. Identifying immune biomarkers of disease progression and therapeutic intervention is essential to evaluating responses to therapy at early stages, predicting which patients might benefit from treatment. Defining CD8+ islet autoreactivity has already proven valuable in the context of clinical islet transplantation. In this article we provide an overview of the evidence for CD8+ T‑cell involvement in Type 1 diabetes, the antigens they recognize, tools to detect these and strategies to monitor islet autoimmune responses during treatment.