Immune Modulation for Prevention of Type 1 Diabetes

Immune Modulation for Prevention of Type 1 Diabetes
Presentation by: Peter A. Gottlieb, MD
Barbara Davis Center
University of Colorado Health Sciences Center Denver, CO


Main Points

* Type 1 diabetes is an autoimmune disease
* It is a predictable disease with different phases
* Approaches to prevention and cure are possible.
* New insulins, medications and devices will improve therapy in the coming decade.

Regulatory Cells
Cellular Mechanics of Autoimmune Type 1 Diabetes
Progression to Diabetes vs Number of Autoantibodies
Type 1a Diabetes: An Autoimmune Disorder
Prevention of Type 1 diabetes
Secondary Prevention
EDIC: Long Term Benefit of Intensive Treatment
Diabetes Control and Complications Trial
Past Trials in New Onset Type 1
Metabolic Effects of AZA and Prednisone at 1 year in New Onset T1DM
Ongoing and Proposed Non-antigen Specific Immunotherapy Trials in New Onset Type 1 DM
Preservation of Pancreatic Production of Insulin (POPPI) study
(Mycophenolate Mofetil and Zenapax)
Mycophenolate Mofetil (MMF)
MMF (CellCept)
MMF Toxicities
Activated T cell
POPPI Study
Potential Benefits of the Study
Control Group
Before treatment
1 wk after treatment
Induction of IL-10+CD4+ cells in vivo following
Treatment with hOKT3g1(Ala-Ala)
Antigen Specific Therapy
Insulin
Altered Peptide Ligand
Recent and Ongoing Antigen-specific Immunotherapy Trials in T1DM
Prediabetes
Primary Prevention
Rationale for Oral Insulin
Oral Antigen Protocol
Nutritional Intervention to Prevent
Mechanistic Studies
Key Elements of Successful Clinical Trials

Immune Modulation for Prevention of Type 1 Diabetes.ppt