Evidence map›Paper›PMID 41673026›Full record

ArticleNature communications2026

Integrated histopathology of the human pancreas throughout stages of type 1 diabetes progression.

Verena van der Heide, Sara McArdle, Michael S Nelson, Karen Cerosaletti, Sacha Gnjatic, Zbigniew Mikulski, Amanda L Posgai, Irina Kusmartseva, Mark A Atkinson, Dirk Homann

Abstract read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Verena van der Heide *Marc and Jennifer Lipschultz Precision Immunology Institute, Department of Immunology and Immunotherapy, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA.ORCID http://orcid.org/0000-0002-3602-4405
Sara McArdle *Microscopy and Histology Core Facility, La Jolla Institute for Immunology, La Jolla, CA, USA.ORCID http://orcid.org/0000-0003-3795-3772
Michael S NelsonDepartment of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.ORCID http://orcid.org/0000-0003-0480-5597
Karen CerosalettiCenter for Translational Immunology, Benaroya Research Institute, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-7403-6239
Sacha GnjaticMarc and Jennifer Lipschultz Precision Immunology Institute, Department of Immunology and Immunotherapy, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA.ORCID http://orcid.org/0000-0001-5643-9520
Zbigniew MikulskiMicroscopy and Histology Core Facility, La Jolla Institute for Immunology, La Jolla, CA, USA.
Amanda L PosgaiDepartment of Pathology, Immunology, and Laboratory Medicine, University of Florida Diabetes Institute, College of Medicine, Gainesville, FL, USA.ORCID http://orcid.org/0000-0002-9491-0958
Irina KusmartsevaDepartment of Pathology, Immunology, and Laboratory Medicine, University of Florida Diabetes Institute, College of Medicine, Gainesville, FL, USA.ORCID http://orcid.org/0000-0003-2614-0813
Mark A AtkinsonDepartment of Pathology, Immunology, and Laboratory Medicine, University of Florida Diabetes Institute, College of Medicine, Gainesville, FL, USA.ORCID http://orcid.org/0000-0001-8489-4782
Dirk HomannMarc and Jennifer Lipschultz Precision Immunology Institute, Department of Immunology and Immunotherapy, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA. dxh2185@miami.edu.ORCID http://orcid.org/0000-0002-7622-5754

Funding

Translational Research CoreP30DK020541 · NIDDK · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI JEFFREY E. PESSIN · 2015 to 2026
$27.7M
High-Dimensional Immune Monitoring of NCI-Supported Immunotherapy TrialsU24CA224319 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Sacha Gnjatic, Seunghee Kim-Schulze · 2017 to 2026
$21.5M
Integrated Functional Histopathology of the Diabetic Human PancreasR01AI134971 · NIAID · LA JOLLA INSTITUTE FOR IMMUNOLOGY · PI HOMANN, DIRK, VON HERRATH, MATTHIAS G. · 2018 to 2022
$3.5M
Characterizing and predicting colitis in immune checkpoint blockade-treated cancer patientsU01DK124165 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI COLOMBEL, JEAN-FREDERIC, FAITH, JEREMIAH JAMES · 2020 to 2024
$2.9M
Mapping Essential Elements and Toxic Metals in the Human Pancreas in Health and DiseaseR21ES027916 · NIEHS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ARORA, MANISH, HOMANN, DIRK · 2018 to 2019
$466k
JDRF 3-PDF-2018-575-A-NNCI NIH HHS U24 CA224319NIAID NIH HHS R01 AI134971NIDDK NIH HHS P30 DK020541NIDDK NIH HHS U01 DK124165NIEHS NIH HHS R21 ES027916U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI) CA196521U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI) CA224319U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI) CA234212U.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious Diseases (NIAID) AI134971U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (National Institute of Diabetes & Digestive & Kidney Diseases) DK020541U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (National Institute of Diabetes & Digestive & Kidney Diseases) DK124165U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (National Institute of Diabetes & Digestive & Kidney Diseases) DK130425U.S. Department of Health & Human Services | NIH | National Institute of Environmental Health Sciences (NIEHS) ES027916
6 · The paper itself

Abstract

Type 1 diabetes (T1D) is a progressive autoimmune condition that culminates in loss of insulin-producing beta cells. Pancreatic histopathology provides essential insights into disease initiation/progression yet an integrated perspective onto in situ pathogenic processes is lacking. Here, we combined multiplexed immunostaining, high-magnification whole-slide imaging, digital pathology, and semi-automated image analyses to interrogate pancreatic tail and head sections across T1D stages, including at-risk and at-onset cases. Deconvolution of architectural features, endocrine cell composition, immune cell burden, and spatial relations of ~25,000 islets effectively contextualizes previously established and additional pancreatic hallmarks in health and T1D. Our results reveal a spatially homogenous and islet size-contingent architectural organization of the endocrine pancreas, a notable coordination of organ-wide pathogenic processes, and multiple histopathological correlates that foreshadow distinctive T1D histopathology already at the preclinical stage. Altogether, we propose a revised natural history of T1D with implications for further histopathological investigations and considerations of pathogenetic modalities.

Indexed as

Diabetes Mellitus, Type 1Islets of LangerhansPancreasDisease ProgressionFemaleHumansInsulin-Secreting CellsMale

Identifiers

PMID41673026
PMCPMC13168456

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.