Identifying the ‘Achilles heel’ of type 1 diabetes

M. Battaglia, J. H. Buckner, M. K. Levings, S. J. Richardson, F. S. Wong*, T. I. Tree

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


When Thetis dipped her son Achilles into the River Styx to make him immortal, she held him by the heel, which was not submerged, and thus created a weak spot that proved deadly for Achilles. Millennia later, Achilles heel is part of today’s lexicon meaning an area of weakness or a vulnerable spot that causes failure. Also implied is that an Achilles heel is often missed, forgotten or under-appreciated until it is under attack, and then failure is fatal. Paris killed Achilles with an arrow ‘guided by the Gods’. Understanding the pathogenesis of type 1 diabetes (T1D) in order to direct therapy for prevention and treatment is a major goal of research into T1D. At the International Congress of the Immunology of Diabetes Society, 2018, five leading experts were asked to present the case for a particular cell/element that could represent ‘the Achilles heel of T1D’. These included neutrophils, B cells, CD8+ T cells, regulatory CD4+ T cells, and enteroviruses, all of which have been proposed to play an important role in the pathogenesis of type 1 diabetes. Did a single entity emerge as ‘the’ Achilles heel of T1D? The arguments are summarized here, to make this case.

Original languageEnglish
Pages (from-to)167-178
Number of pages12
JournalClinical and Experimental Immunology
Issue number2
Publication statusPublished - 23 Apr 2021


  • B cells
  • cytotoxic T cells
  • neutrophils
  • regulatory T cells
  • viral


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