Biomarkers for immune intervention trials in type 1 diabetes

Clin Immunol. 2013 Dec;149(3):286-96. doi: 10.1016/j.clim.2013.02.009. Epub 2013 Feb 27.

Abstract

After many efforts to improve and standardize assays for detecting immune biomarkers in type 1 diabetes (T1D), methods to identify and monitor such correlates of insulitis are coming of age. The ultimate goal is to use these correlates to predict disease progression before onset and regression following therapeutic intervention, which would allow performing smaller and shorter pilot clinical trials with earlier endpoints than those offered by preserved β-cell function or improved glycemic control. Here, too, progress has been made. With the emerging insight that T1D represents a heterogeneous disease, the next challenge is to define patient subpopulations that qualify for personalized medicine or that should be enrolled for immune intervention, to maximize clinical benefit and decrease collateral damage by ineffective or even adverse immune therapeutics. This review discusses the current state of the art, setting the stage for future efforts to monitor disease heterogeneity, progression and therapeutic intervention in T1D.

Keywords: Autoantibodies; C-peptide; Endpoint; T cells.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoantibodies / immunology
  • Biomarkers / metabolism
  • C-Peptide / metabolism
  • Clinical Trials as Topic
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / therapy*
  • Disease Progression
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Immunotherapy*
  • Insulin / metabolism
  • Islets of Langerhans Transplantation
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / pathology

Substances

  • Autoantibodies
  • Biomarkers
  • C-Peptide
  • Hypoglycemic Agents
  • Insulin