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Immunotherapy for Type 1 diabetes: past and future

Mona Landin-Olsson & Charlotte Erlanson-Albertsson

Type 1 diabetes is regarded as an autoimmune disease and, in accordance with this, trials using immune suppression and general or specific immune modifications have been carried out. Most trials have been successful in animals, but it has not been possible to reproduce these results in humans. Some effects have, however, been observed in subgroups of patients, but no drug has shown a general effectiveness. The side effects have been acceptable. The failure has been suggested to be due to insufficient doses, late start or the need for a combination of drugs. It could also simply be that this is an inappropriate way to attack the disease. It is therefore time for a new approach in the battle against Type 1 diabetes. The autoimmune findings could be an expression of defense and an effort to restore damaged b cells. More effort has to be put into a critical evaluation of environmental factors to find the very early agents promoting Type 1 diabetes.