A century later, still fighting back: antigen?specific immunotherapies for type 1 diabetes

Type 1 diabetes (T1D) is a chronic metabolic disease caused by the autoimmune destruction of insulin-producing ?-cells. Ever since 1920s, fate patients suffering from T1D was dramatically improved owing to isolation and production insulin, scientific field has largely progressed as result evidence gathered about its underpinnings mechanisms. The last years have seen this knowledge transformed into actual antigen-specific immunotherapies with potential restore selectively breach tolerance ?-cell autoantigens halt aggression. However, so far, results both prevention reversion trials in been rather discouraging, there still an urgent need optimize those their associated factors, for example, posology administration patterns, route timing. In review, we look back on what achieved century identify main driving attack T1D. Then, take deep dive numerous trialed ones at preclinical phase, ranging peptides, proteins agent combinations gene transfer, nanoparticles, cell-based strategies novel approaches exploiting naturally occurring tolerogenic processes. Finally, provide insight several features be considered clinical trial, ideal time point intervention biomarkers needed monitoring successful regulatory effect immunotherapy. Although further research optimization remain imperative, development therapeutic armamentarium against autoimmunity certainly advancing confident step.