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Diabetologia

Erschienen in:

05.01.2019 | Commentary

A future for CD3 antibodies in immunotherapy of type 1 diabetes

verfasst von: Lucienne Chatenoud

Erschienen in: Diabetologia | Ausgabe 4/2019

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More than 30 years have passed since the first immunotherapy trials in autoimmune insulin-dependent type 1 diabetes were conducted [1]. At this time, it was already apparent, given the compelling observations of the central role of CD4 and CD8 autoreactive T cells in the destruction of insulin-secreting beta-cells, that the immune system of patients would be the most effective drug target, though few tools were available. Small molecule immunosuppressants, such as ciclosporin, were transforming treatment of organ transplant rejection as they proved to be more effective than the conventional therapies, corticosteroids and azathioprine. Based on these observations, ciclosporin was tested in patients with recently diagnosed type 1 diabetes. The results of these first trials provided a fundamental proof-of-concept: that it was possible to effectively treat patients with established hyperglycaemia because, contrary to the prevailing dogma, even after disease diagnosis, a significant mass of beta-cells remained such that recovery of metabolic control was possible if treatment was started early enough [2‐4]. However, the other important conclusion that was immediately evident, and which explains why ciclosporin was not developed further, was that the associated side effects of the drug treatment meant that the risks outweighed the benefits. Indeed, any antigen non-specific immunosuppression strategy that required chronic administration to maintain effectiveness, as did ciclosporin in type 1 diabetes, exposed patients, including children and young adults, to unacceptable risks of over-immunosuppression and off-target toxicities. …

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Titel: A future for CD3 antibodies in immunotherapy of type 1 diabetes
verfasst von: Lucienne Chatenoud
Publikationsdatum: 05.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Diabetologia / Ausgabe 4/2019
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-018-4808-7

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