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Autoantigen Treatment in Type 1 Diabetes: Unsolved Questions on How to Select Autoantigen and Administration Route
Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.ORCID iD: 0000-0003-1695-5234
2020 (English)In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, ISSN 1661-6596, Vol. 21, no 5, article id 1598Article, review/survey (Refereed) Published
Abstract [en]

Autoantigen treatment has been tried for the prevention of type 1 diabetes (T1D) and to preserve residual beta-cell function in patients with a recent onset of the disease. In experimental animal models, efficacy was good, but was insufficient in human subjects. Besides the possible minor efficacy of peroral insulin in high-risk individuals to prevent T1D, autoantigen prevention trials have failed. Other studies on autoantigen prevention and intervention at diagnosis are ongoing. One problem is to select autoantigen/s; others are dose and route. Oral administration may be improved by using different vehicles. Proinsulin peptide therapy in patients with T1D has shown possible minor efficacy. In patients with newly diagnosed T1D, subcutaneous injection of glutamic acid decarboxylase (GAD) bound to alum hydroxide (GAD-alum) can likely preserve beta-cell function, but the therapeutic effect needs to be improved. Intra-lymphatic administration may be a better alternative than subcutaneous administration, and combination therapy might improve efficacy. This review elucidates some actual problems of autoantigen therapy in the prevention and/or early intervention of type 1 diabetes.

Place, publisher, year, edition, pages
MDPI, 2020. Vol. 21, no 5, article id 1598
Keywords [en]
type 1 diabetes; autoantigen treatment; oral administration; combination therapy; GAD-alum; vitamin D; intralymphatic treatment
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-165345DOI: 10.3390/ijms21051598ISI: 000524908500049PubMedID: 32111075Scopus ID: 2-s2.0-85079841671OAI: oai:DiVA.org:liu-165345DiVA, id: diva2:1426752
Note

Funding Agencies|Swedish Child Diabetes Foundation (Barndiabetesfonden); Juvenile Diabetes Research FoundationJuvenile Diabetes Research Foundation; Research Council of Southeast Sweden (FORSS); Diabetesfonden (Swedish Diabetes Association); Diamyd Medical

Available from: 2020-04-27 Created: 2020-04-27 Last updated: 2024-11-20

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Endocrinology and Diabetes

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