Chapter III. Re-establishing Tolerance

Rev Diabet Stud, 2012, 9(4):289-304 DOI 10.1900/RDS.2012.9.289

Type 1 Diabetes Therapy Beyond T Cell Targeting: Monocytes, B Cells, and Innate Lymphocytes

F. Susan Wong1, Li Wen2

1Institute of Molecular and Experimental Medicine, Cardiff School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
2Section of Endocrinology, Department of Medicine, Yale School of Medicine, 333 Cedar Street, New Haven CT 06520, USA
Address correspondence to: F. Susan Wong, e-mail: wongfs@cardiff.ac.uk

Manuscript submitted December 20, 2012; resubmitted January 20, 2013; accepted January 21, 2013.

Keywords: type 1 diabetes, B cell, NOD, Treg cell, dendritic cell, ATG, CD3, monoclonal antibody

Abstract

Recent clinical trials, investigating type 1 diabetes (T1D), have focused mainly on newly diagnosed individuals who have developed diabetes. We need to continue our efforts to understand disease processes and to rationally design interventions that will be safe and specific for disease, but at the same time not induce undesirable immunosuppression. T cells are clearly involved in the pathogenesis of T1D, and have been a major focus for both antigen-specific and non-antigen-specific therapy, but thus far no single strategy has emerged as superior. As T1D is a multifactorial disease, in which multiple cell types are involved, some of these pathogenic and regulatory cell pathways may be important to consider. In this review, we examine evidence for whether monocytes, B cells, and innate lymphocytes, including natural killer cells, may be suitable targets for intervention.

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