DiaPep277® and immune intervention for treatment of type 1 diabetes

•Overview on immune intervention studies with DiaPep277® in type 1 diabetes•Mechanism of action of DiaPep277•Status of immune monitoring throughout DiaPep277® intervention trials

Type 1 diabetes is a chronic immune-mediated disease resulting in destruction of insulin-producing β-cells. Several studies have been performed aiming to halt disease progression after diagnosis; to reduce the increased diabetes risk in islet-autoantibody positive subjects; and to prevent the onset of β-cell autoimmunity in subjects genetically at risk but without autoantibodies. Whereas secondary prevention trials failed, trials in newly diagnosed patients have shown partial success in preserving C-peptide. These studies target T-cells and inflammation and make use of antigen-specific immune modulation or stem cell approaches. However, thus far no immune-based therapeutic regimen has cured type 1 diabetes after its clinical onset or has stabilized the decline of C-peptide to achieve the status of an approved drug. This review summarizes immune intervention trials and the current knowledge of DiaPep277® peptide as a form of immune intervention in type 1 diabetes.