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From bugs to β cells

Description Do ancient microbial irritants offer early life protection against diabetes? One-hundred years ago, the discovery of the hormone insulin by Frederick Banting and Charles Best transformed the prognosis of type 1 diabetes (T1D). Practically overnight, a diagnosis of T1D went from meaning certain suffering and death to being a manageable, albeit difficult, condition that could result in a long and full life. Over the century since that Nobel Prize–winning discovery, there has been monumental progress in the understanding of the basic etiology of diabetes, which is now known to be an autoimmune disease characterized by the destruction of pancreatic insulin-producing β cells (see the figure). However, a cure still evades discovery, and its realization will require a dual approach that tempers autoimmunity while simultaneously restoring endogenous insulin production. Focusing on the latter, our work revealed that the resident microbiome is a promising source of previously undiscovered modulators of host β cells.