Treatment of Type 1 Diabetes is Changing - Breakthrough in Immune Intervention?

Background: Type1 diabetes is an autoimmune disease. An interaction of genetic, immunologic and cell-toxic factors leads to the destruction of insulin producing beta cells in the pancreas of patients with type1 diabetes. A number of immune therapeutics which are to improve the natural progress of the disease are currently evaluated in clinical trials. Methods: Selective research of the literature in databases (pubmed and clinicaltrials. gov, November 2010). Results: Immune therapeutics used in current clinical trials target different mechanisms of the immune system, like antigen presentation (antigen specific therapy, Rituximab), expansion of auto reactive t-cells (anti-CD3), and inflammation via cytokines (IL-1 beta-antagonist). Immune therapeutics are not only applied after diabetes onset adjuvant to intensive insulin therapy, but also as primary prevention in children with a high diabetes risk or as secondary prevention in children, adolescent and adults with positive islet autoantibodies. Conclusion: Adjuvant immune therapeutics and combinations of different therapeutic principles may play an important role for future treatment of type1 diabetes. The evaluation of drug safety will be crucial, so that therapies can be applied in early childhood or as preventive treatment.