title: Impact of disease heterogeneity on treatment efficacy of immunotherapy in Type 1 diabetes: different shades of gray.
abstract: Type 1 diabetes results from selective destruction of insulin-producing pancreatic β-cells by a progressive autoimmune process. Type 1 diabetes proves very heterogeneous in pathology, disease progression and efficacy of therapeutic intervention. Indeed, several immunotherapies that appear ineffective for the entire treated patient population in fact look promising in subgroups of patients. It therefore seems inconceivable that one standard therapy will provide the golden bullet of disease intervention. Instead, personalized medicine may improve immune intervention efficacy rates. We discuss the effect of disease heterogeneity on treatment outcome of immunotherapies, identifying apparent gaps in our understanding of treatment efficacy in subgroups of Type 1 diabetic patients as well as identifying future opportunities for immunotherapy.
authors.affiliation: Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, E3-Q, LUMC, PO Box 9600, NL-2300RC Leiden, The Netherlands.
authors.forename: Nicky J C
authors.initials: NJ
authors.lastname: Woittiez
authors.forename: Bart O
authors.initials: BO
authors.lastname: Roep
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000145:classification / Q000276:immunology / Q000473:pathology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*
keywords: Type 1 diabetes; disease heterogeneity; heterogeneity; immunotherapy; personalized medicine