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Immune Mechanisms and Pathways Targeted in Type 1 Diabetes.


ABSTRACT:

Purpose of review

The immunosuppressive agent cyclosporine was first reported to lower daily insulin dose and improve glycemic control in patients with new-onset type 1 diabetes (T1D) in 1984. While renal toxicity limited cyclosporine's extended use, this observation ignited collaborative efforts to identify immunotherapeutic agents capable of safely preserving β cells in patients with or at risk for T1D.

Recent findings

Advances in T1D prediction and early diagnosis, together with expanded knowledge of the disease mechanisms, have facilitated trials targeting specific immune cell subsets, autoantigens, and pathways. In addition, clinical responder and non-responder subsets have been defined through the use of metabolic and immunological readouts. Herein, we review emerging T1D biomarkers within the context of recent and ongoing T1D immunotherapy trials. We also discuss responder/non-responder analyses in an effort to identify therapeutic mechanisms, define actionable pathways, and guide subject selection, drug dosing, and tailored combination drug therapy for future T1D trials.

SUBMITTER: Jacobsen LM 

PROVIDER: S-EPMC8053389 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Immune Mechanisms and Pathways Targeted in Type 1 Diabetes.

Jacobsen Laura M LM   Newby Brittney N BN   Perry Daniel J DJ   Posgai Amanda L AL   Haller Michael J MJ   Brusko Todd M TM  

Current diabetes reports 20180830 10


<h4>Purpose of review</h4>The immunosuppressive agent cyclosporine was first reported to lower daily insulin dose and improve glycemic control in patients with new-onset type 1 diabetes (T1D) in 1984. While renal toxicity limited cyclosporine's extended use, this observation ignited collaborative efforts to identify immunotherapeutic agents capable of safely preserving β cells in patients with or at risk for T1D.<h4>Recent findings</h4>Advances in T1D prediction and early diagnosis, together wit  ...[more]

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