Immune intervention with T regulatory cells: Past lessons and future perspectives for type 1 diabetes

In type 1 diabetes (T1D), insulin-producing pancreatic β-cells are attacked and destroyed by the immune system. Although man-made insulin is life-saving, it is not a cure and it cannot prevent long-term complications. In addition, most T1D patients would do almost anything to achieve release from the burden of daily glucose monitoring and insulin injection. Despite the formation of very large and promising clinical trials, a means to prevent/cure T1D in humans remains elusive. This has led to an increasing interest in the possibility of using T cells with regulatory properties (Treg cells) as a biological therapy to preserve and restore tolerance to self-antigens. In the present review we will attempt to consolidate learning from the past and to describe what we now believe could in the future become a successful Treg-cell based immune intervention in T1D.

► Type 1 diabetes (T1D) is an autoimmune disease in which insulin-producing beta cells are destroyed by the immune system.
► CD4+ T regulatory (Treg) cells play a particularly essential role in maintaining immune tolerance and can be used to cure autoimmunity.
► Cell therapies with Treg cells in T-cell-mediated diseases are now a reality and it is time to extend this approach to T1D.