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Proposal for generating new beta cells in a muted immune environment for type 1 diabetes
Author(s) -
Levetan Claresa,
Pozzilli Paolo,
Jovanovic Lois,
Schatz Desmond
Publication year - 2013
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2435
Subject(s) - medicine , diabetes mellitus , clinical trial , type 1 diabetes , immune system , type 2 diabetes , insulin , transplantation , pancreatic islets , beta cell , immunology , islet , endocrinology
Abstract Background Over the past decade, many immune tolerance agents have shown promise in the non‐obese diabetic mouse model for prevention and reversal of type 1 diabetes but have not been successful in clinical trials among recently diagnosed type 1 patients. The trials from decades ago using Cyclosporine A in significantly lower dosages than used for organ transplantation and in similar dosages that have increased T regulatory cell populations in conditions such as atopic dermatitis, demonstrated very high initial insulin‐free remission rates when administered immediately after diagnosis. Over time, all newly diagnosed type 1 patients given Cyclosporine A required insulin. Human trials with immune tolerance agents suggest that in addition to an immune tolerance agent, a beta cell regeneration agent may also be necessary to induce long‐lasting remission among patients with recent onset type 1 diabetes. Methods A randomized, double‐blind prospective trial among recent onset type 1 diabetes patients has been designed using Cyclosporine A and a proton‐pump inhibitor, which increases gastrin levels and has been shown to work through the Reg receptor to transform pancreatic duct cells into islets. © 2013 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons, Ltd.