Does autoantigen administration inhibit recurrence of type 1 diabetes in transplanted islets?

Type 1 diabetes is a chronic disease with a subclinical prodromal period resulting from autoimmune destruction of pancreatic beta-cells. At the time of clinical symptoms of diabetes, the majority of islets have irreversibly been destroyed. Thus, the only cure for type 1 diabetes is pancreas (or islet) transplantation. To reach this goal, both allograft rejection and recurrent autoimmunity must be overcome. These have partly been achieved at the cost of lifelong immunosuppression, however, the risk to benefit ratio for immunosuppressive drugs to insulin usage remains obscure. To eliminate the need for immunosuppression, several tolerance induction protocols have been developed which particularly target alloimmune responses, whereas no tolerance induction protocol that particularly prevents the recurrence of autoimmunity has been suggested. It is hypothesized that autoantigen-based interventions may inhibit the recurrence of type 1 diabetes in transplanted pancreas (or islets) through the induction of specific tolerance to beta-cell autoantigens.