title: Immunomodulation with heat shock protein DiaPep277 to preserve beta cell function in type 1 diabetes - an update.
abstract: BACKGROUND
  Type 1 diabetes is a chronic autoimmune disease in which pancreatic beta cells are selectively destroyed. Ultimately hyperglycemia develops and insulin substitution becomes necessary. Immunomodulation aims at arresting this autoimmune attack. DiaPep277, the major T-cell epitope of heat shock protein 60 (hsp60), has been shown to be effective as a modulator of the immune system in type 1 diabetes and is the focus of this review.
  
  
  METHODS
  A literature search of Pubmed listed publications covering 1990 - 2009 and a website search of the licensing company were performed.
  
  
  RESULTS
  DiaPep277 has been successfully employed in animal models and has been investigated in Phase I - III studies in humans. A combined analysis of the Phase II trials showed a significant preservation of beta cell function in adults without adverse effects, but HbA1c was not changed. A Phase III clinical trial is ongoing, and a second Phase III trial will start in early 2010. Addressing the underlying autoimmune process is the call of the future in type 1 diabetes.
  
  
  CONCLUSIONS
  Use of Diapep277 is a promising therapeutic strategy currently being tested in Phase III trials.
authors.affiliation: Justus Liebig University, Medical Clinic and Policlinic 3, Rodthohl 6, 35385 Giessen, Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Fischer
authors.forename: Dana
authors.initials: D
authors.lastname: Elias
authors.forename: Reinhard G
authors.initials: RG
authors.lastname: Bretzel
authors.forename: Thomas
authors.initials: T
authors.lastname: Linn
mesh_terms: D000818:Animals; D018834:Chaperonin 60 / Q000009:adverse effects / Q000627:therapeutic use*; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D050417:Insulin-Secreting Cells / Q000187:drug effects*; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D014611:Vaccination
chemical_list: D018834:Chaperonin 60; C447781:DiaPep 277; D007155:Immunologic Factors; D010446:Peptide Fragments