There is common agreement indicating that the occurrence of multiple antibodies against islet autoantigens serves as a surrogate marker of disease in primary or secondary intervention strategies aimed at halting the disease process. To date, a number of intervention strategies are in the pipeline and some of them seem promising. These therapies include anti-CD3 humanized monoclonal antibody; antilymphocyte serum; and a number of antigen-specific therapies, such as oral insulin. The DPT-1 has recently performed a subgroup analysis suggesting potential benefit of oral insulin for relatives with high insulin autoantibody titers. A trial conducted by Neurocrine using an altered insulin peptide ligand of insulin B:9-23 is currently underway in humans in which the peptide is delivered without the use of an adjuvant or other immunomodulation. Many of these antigen-specific therapies for T1DM and other autoimmune diseases have not been approved. There is both a growing effort and a large opportunity for exploring new specific strategies alone or in combination with immunomodulation. It is possible that gene-engineered cell therapeutics if combined with immunotherapy may effectively replace the pancreatic β-cell loss in T1DM. The hope to induce pancreatic islet regeneration and, ultimately, to transplant insulin-producing cells with a sustained secretagogue capacity propels confidence that the cure of T1DM is within reach.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health