title: Concise Review: Cell-Based Therapies and Other Non-Traditional Approaches for Type 1 Diabetes.
abstract: The evolution of Type 1 diabetes (T1D) therapy has been marked by consecutive shifts, from insulin replacement to immunosuppressive drugs and targeted biologics (following the understanding that T1D is an autoimmune disease), and to more disease-specific or patient-oriented approaches such as antigen-specific and cell-based therapies, with a goal to provide efficacy, safety, and long-term protection. At the same time, another important paradigm shift from treatment of new onset T1D patients to prevention in high-risk individuals has taken place, based on the hypothesis that therapeutic approaches deemed sufficiently safe may show better efficacy if applied early enough to maintain endogenous β cell function, a concept supported by many preclinical studies. This new strategy has been made possible by capitalizing on a variety of biomarkers that can more reliably estimate the risk and rate of progression of the disease. More advanced ("omic"-based) biomarkers that also shed light on the underlying contributors of disease for each individual will be helpful to guide the choice of the most appropriate therapies, or combinations thereof. In this review, we present current efforts to stratify patients according to biomarkers and current alternatives to conventional drug-based therapies for T1D, with a special emphasis on cell-based therapies, their status in the clinic and potential for treatment and/or prevention.
authors: Department of Medicine, Columbia Center for Translational Immunology and Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, USA.
authors: Remi J
authors: RJ
authors: Creusot
authors: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors: Manuela
authors: M
authors: Battaglia
authors: Division of Stem Cell Transplantation and Regenerative Medicine, Department of Pediatrics, Stanford University School of Medicine Stanford, CA, USA.
authors: Maria-Grazia
authors: MG
authors: Roncarolo
authors: Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine Stanford, CA, USA.
authors: C Garrison
authors: CG
authors: Fathman
mesh_terms: D015551:Autoimmunity; D015415:Biomarkers / Q000378:metabolism; D064987:Cell- and Tissue-Based Therapy; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D050417:Insulin-Secreting Cells / Q000473:pathology* / Q000637:transplantation; D045164:Mesenchymal Stem Cell Transplantation; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism
chemical_list: D015415:Biomarkers; D007328:Insulin
keywords: Antigen-specific; Autoimmunity; Cell therapy; Immunoregulation; Prevention; T cells; Type 1 diabetes