Examples of enzymatic deamidation or citrullination of self-antigens (e.g., proinsulin, C-peptide, GAD65, IA-2, GRP78, IAPP), as a consequence of activation of peptidyl arginine deiminase (PAD) or tissue transglutaminase (tTG) detected in pancreatic β cells in response to stress or primary islets from T1D patients, illustrate how the islet microenvironment can drive autoimmunity (10, 11). Here, GAD2 is linked to type 1 diabetes mellitus.