Questioning Four Preconceived Ideas on Immunotherapy of Clinical Type 1 Diabetes: Lessons from Recent CD3 Antibody Trials

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Questioning Four Preconceived Ideas on Immunotherapy of Clinical Type 1 Diabetes: Lessons from Recent CD3 Antibody Trials

Publisher
SBDR - Society for Biomedical Diabetes Research
Publication Date
Jan 01, 2005
Source
PMC
Keywords
Disciplines
  • Design
  • Medicine
License
Unknown

Abstract

Microsoft Word - Chatenoud_editorial_designed_102605.doc EDITORIAL www.The-RDS.org 116 DOI 10.1900/RDS.2005.2.116 P Questioning Four Preconceived Ideas on Immunotherapy of Clinical Type 1 Diabetes: Lessons from Recent CD3 Antibody Trials Lucienne Chatenoud and Jean-François Bach Université René Descartes Paris 5, INSERM U580, Hôpital Necker-Enfants Malades, Paris, France. Address correspondence to: Jean-François Bach, e-mail: [email protected] Introduction atients presenting type 1 diabetes (T1D) are cur- rently treated with insulin substitutive therapy that is remarkably successful. The treatment has, however, two major limitations that cannot be underestimated due to the major problems and/or discomfort they create, particularly in the numerous patients with un- stable metabolic control or insufficient compliance to treatment. The first limitation is degenerative compli- cations that remain an important concern even if their frequency has been dramatically reduced in patients with good metabolic control. The second is the worri- some daily constraints and risks (especially hypoglyce- mia) linked to regular insulin administration. Several alternatives to palliative insulin therapy have been pro- posed: pancreas or islet transplantation, β-cell regen- eration and immunotherapy. The last strategy, which is in many regards the most straightforward and does not expose patients to the hazards and complications of cell therapy and transplantation, was initiated in the 1980s using cyclosporin in patients presenting new- onset T1D [1-3]. Successful remission of disease was obtained with very limited side effects. When the drug was administered at reasonable doses, neither chronic nephrotoxicity nor infections were observed [1-5]. Thus, ten years after cyclosporin treatment, patients from the French study showed perfectly normal renal function as assessed by creatinine and paraaminohypu- ric (PAH) ac

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