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Immune responses to modified self-proteins are involved in the pathogenesis of a number of autoimmune diseases. Type 1 diabetes (T1D) is a prototypical organ-specific autoimmune disease that results from the T-cell–mediated destruction of insulin-producing β-cells within pancreatic islets. The stages of T1D development allow for the measurement of immune responses prior to clinical symptom onset. In our study, we measured T-cell responses from genetically at-risk individuals to both naturally occurring insulin and hybrid insulin peptides, novel neo-epitopes implicated in T1D pathogenesis. Our results have important implications to stratify the risk of developing T1D and identifying individuals who may benefit from immune intervention studies.

All study data are included in the article and/or supporting information.