title: Proposal for generating new beta cells in a muted immune environment for type 1 diabetes.
abstract: BACKGROUND
  Over the past decade, many immune tolerance agents have shown promise in the non-obese diabetic mouse model for prevention and reversal of type 1 diabetes but have not been successful in clinical trials among recently diagnosed type 1 patients. The trials from decades ago using Cyclosporine A in significantly lower dosages than used for organ transplantation and in similar dosages that have increased T regulatory cell populations in conditions such as atopic dermatitis, demonstrated very high initial insulin-free remission rates when administered immediately after diagnosis. Over time, all newly diagnosed type 1 patients given Cyclosporine A required insulin. Human trials with immune tolerance agents suggest that in addition to an immune tolerance agent, a beta cell regeneration agent may also be necessary to induce long-lasting remission among patients with recent onset type 1 diabetes.
  
  
  METHODS
  A randomized, double-blind prospective trial among recent onset type 1 diabetes patients has been designed using Cyclosporine A and a proton-pump inhibitor, which increases gastrin levels and has been shown to work through the Reg receptor to transform pancreatic duct cells into islets.
authors.affiliation: Department of Endocrinology, Chestnut Hill Hospital, Philadelphia, PA, USA.
authors.forename: Claresa
authors.initials: C
authors.lastname: Levetan
authors.forename: Paolo
authors.initials: P
authors.lastname: Pozzilli
authors.forename: Lois
authors.initials: L
authors.lastname: Jovanovic
authors.forename: Desmond
authors.initials: D
authors.lastname: Schatz
mesh_terms: D000818:Animals; D016572:Cyclosporine / Q000008:administration & dosage*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000276:immunology*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005755:Gastrins / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007108:Immune Tolerance; D050417:Insulin-Secreting Cells / Q000502:physiology*; D064747:Lansoprazole / Q000008:administration & dosage*; D051379:Mice; D010183:Pancreatic Ducts / Q000166:cytology* / Q000187:drug effects; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000494:pharmacology; D012038:Regeneration / Q000276:immunology*; D013045:Species Specificity
chemical_list: D005755:Gastrins; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D016572:Cyclosporine
keywords: beta cell regeneration; immune protection; type 1 diabetes