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J R Soc Med 1993;86:217-219
© 1993 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 86, Issue 4 217-219, Copyright © 1993 by Royal Society of Medicine

ORIGINAL ARTICLES

Heat shock protein and the double insult theory for the development of insulin dependent diabetes

DF Child, CJ Smith and CP Williams
Wrexham Maelor Hospital, Clwyd, Wales.

Heat shock proteins (HSP) are the most widely conserved group of proteins in phylogeny and play an important role in infection and autoimmunity. HSP65 has been suggested as the primary antigen in insulin dependent diabetes while an alternative antigen glutamic acid decarboxylase (GAD), has similar amino acid sequences. A 'double insult theory' for the development of insulin dependent diabetes is suggested whereby a bacterial infection leads to the production of HSP antibody. If during a 'window of opportunity' this is followed by a viral infection of the islet cells this could, in certain histocompatibility locus antigen (HLA) groups only, lead to the production of HSPs on the cell surface and a destructive autoimmune reaction.
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