Anti-cytokine therapies in T1D: Concepts and strategies

Therapeutic targeting of proinflammatory cytokines is clinically beneficial in several autoimmune disorders. Several of these cytokines are directly implicated in the pathogenesis of type 1 diabetes, suggesting opportunities for design of clinical trials in type 1 diabetes that incorporate selective cytokine blockade as a component of preventative or interventional immunotherapy. The rationale and status of inhibitory therapy directed against IL-1, TNF, IL-12, IL-23, and IL-6 are discussed, towards a goal of using cytokine inhibition as a therapeutic platform to establish an in vivo milieu suitable for modulating the immune response in T1D.

► Cytokine inhibition supports regulatory immunological mechanisms.
► Cytokines influence immunologic determinism in tissue microenvironments.
► Cytokine blockade can establish a foundation for antigen-specific therapy.
► Several cytokine inhibitors should be evaluated in T1D clinical trials.