title: Immunotherapies currently in development for the treatment of type 1 diabetes.
abstract: BACKGROUND
  Type I diabetes (T1DM) is an autoimmune disorder that affects the pancreas' ability to produce insulin. While T1DM can be managed using insulin therapy, patients face financial burden, serious complications and premature mortality, from the disease. Efforts have sought to define and ultimately suppress the underlying autoimmune attack that results in T1DM.
  
  
  METHODS
  The authors lay out promising immunosuppressive and immunomodulating drugs currently in development for T1DM and outline options for future immune treatment for the disorder. There have been several pharmacological strategies to combat the immune attack which will serve as the organization for this review: antigen-specific therapies; monoclonal antibodies; fusion proteins; alternate Treg affectors.
  
  
  CONCLUSIONS
  Immunosuppression and immunomodulation studies in T1DM demonstrated differing levels of slowing the progression of the immune attack; however, no single therapeutic approach provides a lasting halt of the immune attack and remission of the disease. The immunosuppressants (teplizumab, rituximab and abatacept) show promise in slowing the T1DM progressions for a specific subpopulation of T1DM patients, but this approach appears temporary and has the potential for unwanted side affects. Combination therapies may have the greatest chance of achieving durable cessation of the T1DM autoimmune attack.
authors.affiliation: a 1 University of Maryland School of Medicine , 3805 Greenway, Baltimore, MD 21218, USA.
authors.forename: Ian C
authors.initials: IC
authors.lastname: Davis
authors.affiliation: b 2 Johns Hopkins University , 10-B E 21st St, Baltimore, MD 21218, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Randell
authors.affiliation: c 3 University of Maryland School of Medicine , 22 South Greene St. N3W42, Baltimore, MD 21201, USA +1 41 0328 2488 ; +1 41 0328 8688 ; sdavis@medicine.umaryland.edu.
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Davis
mesh_terms: D000818:Animals; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000628:therapy*; D018450:Disease Progression; D006801:Humans; D056747:Immunomodulation / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D007328:Insulin / Q000378:metabolism
chemical_list: D007166:Immunosuppressive Agents; D007328:Insulin
keywords: Treg affectors; antigen-specific immunotherapies; fusion proteins; immunomodulation; immunosuppression; monoclonal antibodies; type 1 diabetes