The challenge of modulating β-cell autoimmunity in type 1 diabetes

Publication date: Available online 24 October 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Mark A Atkinson, Bart O Roep, Amanda Posgai, Daniel C S Wheeler, Mark PeakmanSummaryWith the conceptual advance about four decades ago that type 1 diabetes represents an autoimmune disease, hope arose that immune-based therapies would soon emerge to prevent and reverse the disorder. However, despite dozens of clinical trials seeking to achieve these goals, the promise remains unfulfilled, at least in a pragmatic form. With the benefit of hindsight, several important reasons are likely to account for this disappointing outcome, including failure to appreciate disease heterogeneity, inappropriate use of rodent models of disease, inadequacies in addressing the immunological and metabolic co...

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