Читать книгу Handbook of Diabetes - Rudy Bilous - Страница 51

This staging has helped in the design of clinical prevention trials. Early studies focused on antigen specific (by early exposure to intravenous or oral insulin), or immunosuppressive approaches. Neither proved to be successful, partly because of the difficulty in recruiting patients at a potentially reversible stage of their disease. The most successful study used an anti‐CD3 antibody which decreased the actions of CD8 T lymphocytes on target β cells. Teplizumab was given for 14 days in a randomised controlled trial to 76 high risk (Stage 2) individuals. The intervention delayed the diagnosis of type 1 diabetes by a median of 24 months and was well tolerated, although there was a significant reactivation of EB virus disease in those with evidence of previous infection. This proof of concept trial will likely lead to further studies of this and other agents, and several are ongoing.