Читать книгу Handbook of Diabetes - Rudy Bilous - Страница 54

The Barts–Windsor study was the first prospective family study in type 1 diabetes and was created by the fortuitous collaboration between Andrew Cudworth (then at St Bartholomew’s Hospital) and John Lister who was the diabetologist in Windsor and who kept a file index of all new cases of type 1 diabetes that he had seen in the district. Around 200 families with a proband with type 1 diabetes and an unaffected sibling were identified and serum collected from as many family members as possible. The findings contributed to what Edwin Gale termed a paradigm shift in the thinking around the aetiology of type diabetes (see 2001 reference below for masterful description). The original objective was to detect the viral culprit for type 1 diabetes. Instead, they confirmed the autoimmune basis of the disease; the clinically silent but immunologically active stage in individuals who had islet cell and GAD autoantibodies years before developing diabetes; and the causative links with some HLA antigens and the protective nature of others. Sadly, Andrew died just as the study was producing its most impressive results, but it remains a fine example of how happenchance and clinical diligence can combine to change our thinking about disease in fundamental ways.