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While a small fraction of granules undergoes glucose\u2010stimulated exocytosis, excess, aged, or immature granules can be degraded through crinophagy, a lysosomal pathway in which secretory granules fuse with lysosomes to form crinosomes. Recent immunopeptidomic studies suggest that crinosomes are not merely disposal compartments but antigen\u2010editing organelles that remodel insulin granule cargo into pathogenic epitopes. These include free insulin B\u2010chain peptides, hybrid insulin peptides, post\u2010translationally modified insulin and C\u2010peptide epitopes, and stress\u2010induced insulin sequence variants such as insulin B\u2010peptide C19S. Because several crinosome\u2010associated epitopes are poorly represented in the thymus, crinophagy may create a peripheral antigen repertoire that permits escape from central tolerance and activation of autoreactive T cells in islets and draining lymphoid tissues. This review discusses the physiology of \u03b2\u2010cell granule turnover, the mechanisms of crinosome\u2010associated neoantigen generation, and their implications for T1D pathogenesis, biomarkers, and therapeutic targeting.<\/jats:p>","DOI":"10.1111\/imr.70156","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:27:56Z","timestamp":1785817676000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Disposal to Display: Crinophagy as a \u03b2\u2010Cell Source of Neoantigens in Type 1 Diabetes"],"prefix":"10.1111","volume":"341","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9471-5239","authenticated-orcid":false,"given":"Angela J.","family":"Zou","sequence":"first","affiliation":[{"name":"Division of Immunobiology, Department of Pathology and Immunology Washington University School of Medicine  St. Louis Missouri USA"},{"name":"The Andrew M. and Jane M. 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