Objective:To evaluate the utility of zinc transporter-8 (ZnT8) in the improvement of type 1 diabetes mellitus (T1DM) diagnosis and prediction,and to explore whether ZnT8 is a potential therapeutic target in T l DM.Data Sources:A search was conducted within the medical database PubMed for relevant articles published from 2001 to 2015.The search terms are as follows:ZnT8, type 1 diabetes, latent autoimmune diabetes in adults, type 2 diabetes, islet autoantibodies, zinc supplement, T cells, β cell, immune therapy. We also searched the reference lists of selected articles.Study Selection:English-language original articles and critical reviews concing ZnT8 and the clinical applications of islet autoantibodies in diabetes were reviewed.Results:The basic function of ZnT8 is maintaining intracellular zinc homeostasis,which modulates the process of insulin biosynthesis,storage,and secretion.Autoantibodies against ZnT8 (ZnT8A) and ZnT8-specific T cells are the reliable biomarkers for the identification,stratification,and characterization ofTl DM.Additionally,the results from the animal models and clinical trials have shown that ZnT8 is a diabetogenic antigen,suggesting the possibility of ZnT8-specific immunotherapy as an altative for T1DM therapy.Conclusions:ZnT8 is a novel islet autoantigen with a widely potential for clinical applications in T1DM.However,before the large-scale clinical applications,there are still many problems to be solved.