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Printable Handouts
Navigable Slide Index
- Introduction
- Autoimmune origin of human Type 1 diabetes
- Pathogenesis: insulitis (1)
- Type 1 diabetes is an autoimmune disease
- Immune tolerance
- Breaking tolerance with checkpoint inhibitors
- Restoring immune tolerance
- Immune suppression vs. tolerance
- Can immunological tolerance be acquired?
- Acquired immune tolerance: clinically feasible?(1)
- Acquired immune tolerance: clinically feasible?(2)
- What about autoimmune disease?
- Pathogenesis: insulitis (2)
- Specific features of immune therapy in T1D
- Pathogenesis: insulitis (3)
- Immune therapy for Type 1 diabetes
- The use of antibodies
- Monoclonal anti-CD3 antibodies
- Anti-CD3: evidence in non-obese diabetic mice
- Anti-CD3: mechanism of action (1)
- Anti-CD3: mechanism of action (2)
- Anti-CD3: clinical studies
- Anti-CD3: clinical trial onset <4 weeks
- Antigen non-specific (anti-CD3: onset <4 weeks)
- Anti-CD3: clinical studies (1)
- Anti-CD3: clinical studies (2)
- Other antibodies in Type 1 diabetes
- Immune therapy for Type 1 diabetes
- Which therapy ?
- Therapeutic approach
- Antigen-specific approach: limitations and questions
- How to measure success?
- Assessment of successful immune therapy
- When to treat
- Pathogenesis: natural history of beta cell failure
- Natural history of Type 1 diabetes
- Treatment in preclinical phase (stage 1 or 2)
- Antigen non-specific anti-CD3
- Is tolerance restored?
- Antigen non-specific (1)
- Antigen non-specific (2)
- Barriers to tolerance induction (1)
- Barriers to tolerance induction (2)
- Perspectives
- Thank you!
Topics Covered
- Introduction to the pathogenesis of Type 1 Diabetes (T1D)
- Immune tolerance
- Principles of immune intervention in T1D
- Approaches in immune therapy including the use of antibodies
- Measuring success
- Timing of treatment
- Tolerance restoration
- Barriers to tolerance induction
Links
Series:
- The Immune System - Key Concepts and Questions
- Monoclonal Antibodies as Therapeutic Agents
- Periodic Reports: Advances in Clinical Interventions and Research Platforms
Categories:
Therapeutic Areas:
Talk Citation
Hilbrands, R. (2020, August 31). Antibodies to control or prevent type 1 diabetes [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 5, 2024, from https://doi.org/10.69645/MGNP4700.Export Citation (RIS)
Publication History
Financial Disclosures
- Robert Hilbrands has no commercial/financial relationships to disclose.
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
Transcript
Please wait while the transcript is being prepared...
0:00
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.
0:44
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.