Resumen

AGUIRRE, Miguel A et al. Diabetes mellitus tipo 1 y factores ambientales: La gran emboscada. Rev. Venez. Endocrinol. Metab. [online]. 2012, vol.10, n.3, pp.122-134. ISSN 1690-3110.

Type 1 Diabetes Mellitus (T1DM) is one of the most studied pathologies to date, not only due to the elevating incidence but also because it is being diagnosed at even earlier ages. T1DM is an autoimmune disease with a very complex genetic background where environmental factors seem to play a very important triggering role. Elements like cesarean section, vitamin D deficiency, early exposure to cow milk proteins, limited exposure to microorganisms during infancy, and the increase of childhood obesity have been related to the development of this disease, converging all the factors into one key feature: loss of intestinal immunological tolerance and the participation of auto-reactive T cells from a susceptible patient. On the other hand, breast milk offers a series of growth and immunological factors, even insulin, which are able to induce a tolerogenic response in the intestinal microenvironment, lowering the probability of any autoimmune phenomena. The following review will expose evidence of the pathophysiological mechanisms involved in each environmental element associated with intestinal immunomodulation and the increase risk of T1DM.

Palabras clave : type 1 diabetes; autoimmunity; intestinal tolerance; microbiota; breast milk.

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