Do immunotherapy and ß cell replacement play a synergistic role in the treatment of type 1 diabetes?

Type 1 diabetes (T1D) is the result of the autoimmune response against pancreatic insulin-producing ß-cells. Its ultimate consequence is β-cell insufficiency-mediated dysregulation of blood glucose control. In terms of T1D treatment, immunotherapy addresses the cause of T1D, mainly through re-setting the balance between autoimmunity and regulatory mechanisms. Regulatory T cells play an important role in this immune intervention. An alternative T1D treatment is β-cell replacement, which can reverse the consequence of the disease by replacing destroyed β-cells in the diabetic pancreas. The applicable insulin-producing cells can be directly obtained from islet transplantation or generated from other cell sources such as autologous adult stem cells, embryonic stem cells, and induced pluripotent stem cells. In this review, we summarize the recent research progress and analyze the possible advantages and disadvantages of these two therapeutic options especially focusing on the potential synergistic effect on T1D treatment. Exploring the optimal combination of immunotherapy and β-cell replacement will pave the way to the most effective cure for this devastating disease.