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Identifying Promising Immunomodulators for Type 1 Diabetes (T1D) and Islet Transplantation.

Nida Ajmal1,2, Maislin C Bogart3, Palwasha Khan1,2

  • 1Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA.

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|December 30, 2024
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Summary

This review explores non-insulin immunomodulators for Type 1 diabetes (T1D) treatment, highlighting drugs like teplizumab that delay T1D onset and others used in clinical trials for beta cell restoration and autoimmune response suppression.

Keywords:
Type 1 diabetesautoimmuneimmunomodulatorspancreatic beta cell

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Area of Science:

  • Immunology
  • Endocrinology
  • Pharmacology

Background:

  • Type 1 diabetes (T1D) is an autoimmune disease causing hyperglycemia due to beta cell destruction.
  • Current insulin therapy manages blood glucose but doesn't halt T1D progression.
  • Effective T1D treatment may necessitate beta cell regeneration and immune system modulation.

Purpose of the Study:

  • To review non-insulin pharmacological therapies, focusing on immunomodulators for Type 1 diabetes.
  • To discuss investigational immunomodulatory drugs, including those recently approved or in late-stage clinical trials.
  • To provide insights into the mechanisms, trial results, and adverse effects of these therapies.

Main Methods:

  • Literature review of non-insulin immunomodulatory drugs for T1D.
  • Analysis of clinical trial data (Phase 3 and higher) from the National Clinical Trial (NCT) database.
  • Inclusion of FDA-approved drugs and those used in islet transplantation.

Main Results:

  • Identified 39 different immunomodulatory investigational drugs for T1D.
  • Highlighted FDA-approved teplizumab for delaying T1D onset (Stage 2).
  • Discussed other immunomodulators like otelixizumab, daclizumab, ladarixin, ATG, alemtuzumab, basiliximab, etanercept, and reparixin in various trial phases and applications.

Conclusions:

  • Immunomodulators represent a promising therapeutic avenue beyond insulin for T1D.
  • Several immunomodulators are in advanced clinical trials or approved for T1D management and islet transplantation.
  • Further research into immunomodulatory mechanisms and clinical efficacy is crucial for T1D reversal.