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Stanford Diabetes Research Center, Stanford University, Stanford, California, USA
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regulate the gene expression important for both pancreatic islet-cell development as well as glucose metabolism, including the insulin gene itself ( Yamagata et al. 1996 a ). Patients with heterozygous loss-of-function mutations in HNF4A have a
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with hyperexpression of HLA class I molecules and insulitis ( Richardson et al. 2009 , 2013 ). There is evidence that enterovirus infections impair beta-cell function ( Gallagher et al. 2015 ), their gene expression, and microRNA regulation ( Kim
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Department of Endocrinology and Diabetes, Westmead Hospital, Sydney, New South Wales, Australia
Garvan Institute of Medical Research, Sydney, New South Wales, Australia
St Vincent’s Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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reported ( Butler et al. 2013 , Yoneda et al. 2013 ). Recent advances in genome sequencing techniques have allowed the mapping of endocrine cell gene expression profile. Chromatin profiling using ATAC-seq (Assay for Transposase Accessible Chromatin
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leucocyte antigen (HLA) genes), activation of the immune system by one or multiple environmental triggers results in a rapid destruction of the pancreatic beta cells ( Eisenbarth 1986 ). This implies a malfunction of the immune system as the culprit. The
