title: Clinical update on the use of immuno modulators (antiCD3, GAD, Diapep277, anti-IL1) in type 1 diabetes.
abstract: In type 1 diabetes, beta cells are attacked and destroyed by auto reactive T cells causing major impairment of blood glucose metabolism and, ultimately, the development of life-threatening complications. Currently, the treatment of this chronic disease is based on the use of endogenous insulin and no curative therapies are available. Treatment approaches in this respect need to be directed toward the primary causes of the disease tackling beta cells' auto reactive T cells. The goal of any curative intervention in type 1 diabetes is the preservation of insulin-secreting cells. This may be achieved by the abrogation of the pathogenic reactivity to beta cell auto antigens while preserving full capacity to generate a normal immune response against foreign antigens. In this review, some of the most promising drugs for immune intervention in type 1 diabetes are presented and discussed including phase 3 clinical trials that involve: DiaPep277, Anti-CD3 Otelixizumab, Glutamic Acid Decarboxylase (GAD) and anti-IL1 receptor antagonist. These approaches are currently being tested in international multicenter trials and all of them have a very similar outcome in terms of a beneficial effect on beta cells.
authors.affiliation: Department of Endocrinology & Diabetes, Università Campus Bio-Medico, Via Álvaro del Portillo 21 - 00128, Rome, Italy. p.pozzilli@unicampus.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Pozzilli
authors.forename: Chiara
authors.initials: C
authors.lastname: Guglielmi
authors.forename: Daria
authors.initials: D
authors.lastname: Maggi
authors.forename: Angela
authors.initials: A
authors.lastname: Carlone
authors.forename: Raffaella
authors.initials: R
authors.lastname: Buzzetti
authors.forename: Silvia
authors.initials: S
authors.lastname: Manfrini
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D017252:CD3 Complex / Q000276:immunology; D018834:Chaperonin 60 / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000276:immunology; D015195:Drug Design; D005968:Glutamate Decarboxylase / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D050417:Insulin-Secreting Cells / Q000276:immunology; D010446:Peptide Fragments / Q000627:therapeutic use; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D001786:Blood Glucose; D017252:CD3 Complex; D018834:Chaperonin 60; C447781:DiaPep 277; D007155:Immunologic Factors; D010446:Peptide Fragments; D017472:Receptors, Interleukin-1; D005968:Glutamate Decarboxylase