Immunotherapies are used to treat various diseases by “boosting” the body’s immune system. Though an approach commonly used in cancer treatment, immunotherapy is also showing promise in the treatment of T1D.
A review examined the different strategies used in clinical trials for T1D immunotherapy:
- Antigen-specific trials
- Anti-inflammatory trials
- T/B cell trials
- Cytokine trials
- Stem cell trials
They found that antigen-specific approaches may be better for individuals at risk for T1D (rather than those diagnosed with the disease). Anti-inflammatory trials did not seem suitable as the primary method of treatment, while T/B cell trials showed positive effects but not enough for insulin independence. While cytokines have also been an area of T1D research interest, these researchers predict that targeting just one cytokine won’t do the trick. Out of all of these strategies, stem cell trials had the most potential for treatment and a possible cure. With autologous hematopoietic stem cell transplantation (AHSCT), patients achieved remission and exogenous insulin independence.
Golimumab: An anti-TNF therapy
Golimumab, a drug currently used for rheumatoid arthritis and ulcerative colitis, was tested recently as a treatment for T1D in research and clinical trials at the University of Buffalo. This drug exhibited preserved beta-cell function, thereby increasing endogenous insulin and reducing patient insulin requirements. The researchers also observed fewer incidences of overly low blood sugar levels in the golimumab-treated children.
Teplizumab: A 30-year research journey
A clinical trial at UCSF used a two-week course of teplizumab, an anti-CD3 monoclonal antibody, in individuals with a high risk of T1D. This treatment reduced the annual diagnoses of the participants by 60% and delayed the median time to diagnosis by two years. First developed in 1985, the drug is the first to have been able to delay and prevent diagnosis of diabetes, making this a discovery that took over 30 years.
- Ben Nasr, M., D’Addio, F., Usuelli, V., Tezza, S., Abdi, R., & Fiorina, P. (2015). The rise, fall, and resurgence of immunotherapy in type 1 diabetes. Pharmacological research, 98, 31–38. https://doi.org/10.1016/j.phrs.2014.07.004
- University at Buffalo. (2020, June 16). Endogenous insulin production is preserved in Type 1 diabetes with anti-TNF drug. ScienceDaily. Retrieved July 29, 2020 from www.sciencedaily.com/releases/2020/06/200616113906.htm
- Immunotherapy Delays Type 1 Diabetes Onset in People at High Risk. (2020, July 27). Retrieved July 29, 2020, from https://www.ucsf.edu/news/2019/06/414631/immunotherapy-delays-type-1-diabetes-onset-people-high-risk