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Type 1 diabetes is a chronic disease caused by autoimmune destruction of pancreatic
β cells. Individuals with type 1 diabetes are reliant on insulin for survival. Despite
enhanced knowledge related to the pathophysiology of the disease, including interactions
between genetic, immune, and environmental contributions, and major strides in treatment
and management, disease burden remains high. Studies aimed at blocking the immune
attack on β cells in people at risk or individuals with very early onset type 1 diabetes
show promise in preserving endogenous insulin production.
VestergaardSyddanmarkDenmarkLampeterCeredigionUnited-kingdomHerrathNordrhein-westfalenGermanyWasserfallPathirajaCentralBuruli ulcer (BU), caused by Mycobacterium ulcerans, is a devastating necrotizing skin disease. Key to its pathogenesis is mycolactone, the exotoxin virulence factor that is both immunosuppressive and cytotoxic. The discovery that the essential Sec61 translocon is the major cellular target of mycolactone explains much of the disease pathology, including the immune blockade. Sec61 inhibition leads to a loss in production of nearly all cytokines from monocytes, macrophages, dendritic cells and T cells, as well as antigen presentation pathway proteins and costimulatory molecules. However, there has long been evidence that the immune system is not completely incapable of responding to M. ulcerans infection. In particular, IL-1beta was recently shown to be present in BU lesions, and to be induced from M. ulcerans-exposed macrophages in a mycolactone-dependent manner. This has important implications for our understanding of BU, showing that mycolactone can act as the “second signal” for
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