Decoding Paediatric Type 1 Diabetes Through the Gut Immune Pancreas Axis: Integrated Roles of I-FABP, Platelet-Activating Factor, and Micrornas: A Narrative Review

Abstract

Background: Type 1 diabetes (T1D) in children develops when genetic risk, environmental triggers, and the immune system join forces to destroy the pancreatic beta cells. Lately, research is pointing toward trouble in the gut. When the intestinal barrier gets damaged, and the gut microbiota goes off-balance, this can kickstart or worsen islet autoimmunity and early vascular problems.

Main body: This narrative takes a close look at three groups of biomarkers, intestinal fatty acid binding protein (I-FABP), platelet-activating factor (PAF), and certain microRNAs (miRNAs), and makes the case for viewing them together instead of in isolation. High I-FABP means the enterocytes are getting hurt and the gut lining isn’t holding up, which points to a leaky gut barrier.

Conclusion: The integrated gut‑immune‑pancreas axis model presented here may facilitate the identification of novel therapeutic targets and early intervention strategies to prevent or delay paediatric T1D. Prospective validation of these biomarkers in African and other underrepresented populations is urgently needed.