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Antibodies to control or prevent type 1 diabetes

Published on August 31, 2020   29 min

Other Talks in the Series: The Immune System - Key Concepts and Questions

Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms

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My name is Robert Hilbrands from the Diabetes Research Center and the Diabetes Clinic of the Brussels Free University, VUB, in Belgium. Over the last two decades, there have been important advances in immune therapy for patients with autoimmune type 1 diabetes. I will be discussing the role of antibodies that have played a major role in these advances, and have been studied in several well-designed clinical trials. They have been shown to preserve residual pancreatic beta-cell function when treatment is started at the time of diagnosis of the disease. More recently, they have also been effective in delaying the clinical onset of type 1 diabetes in individuals at high risk for developing type 1 diabetes.
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Type 1 diabetes is an autoimmune disease that is characterized by a T-cell mediated, selective destruction of the beta-cells in the pancreas by autoreactive CD4-positive and CD8-positive T-cells. The disease can manifest at any age, but is most frequently diagnosed in young children. Patients with type 1 diabetes present with hyperglycemia at the time of diagnosis, and require immediate insulin treatment to prevent chronic complications from hyperglycemia and ketoacidosis. Insulin treatment has to be maintained for the rest of their lives in order to survive, and this places a very large burden on the life of a type 1 diabetic patient. Strict glycemic control is necessary to prevent chronic micro- and macrovascular complications from type 1 diabetes. Achieving this goal can lead to the occurrence of hypoglycemia with insulin treatment, which can result in serious life-threatening events and also place a lot of stress on the daily life of these patients and their relatives. It is only since the late 1960s that an autoimmune origin of type 1 diabetes has been suggested. This was first suspected after examination of pathological samples of type 1 diabetic patients who died soon after clinical onset. These samples showed an inflammatory infiltrate (which can be seen here) inside and around the islets of Langerhans, as you can see on this slide.

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Antibodies to control or prevent type 1 diabetes

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