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Antigen-Based Vaccination and Prevention of Type 1 Diabetes

  • Pathogenesis of Type 1 Diabetes (D Dabelea, Section Editor)
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Abstract

Insulin-dependent or type 1 diabetes (T1D) is a paradigm for prevention of autoimmune disease: Pancreatic β-cell autoantigens are defined, at-risk individuals can be identified before the onset of symptoms, and autoimmune diabetes is preventable in rodent models. Intervention in asymptomatic individuals before or after the onset of subclinical islet autoimmunity places a premium on safety, a requirement met only by lifestyle–dietary approaches or autoantigen-based vaccination to induce protective immune tolerance. Insulin is the key driver of autoimmune β-cell destruction in the nonobese diabetic (NOD) mouse model of T1D and is an early autoimmune target in children at risk for T1D. In the NOD mouse, mucosal administration of insulin induces regulatory T cells that protect against diabetes. The promise of autoantigen-specific vaccination in humans has yet to be realized, but recent trials of oral and nasal insulin vaccination in at-risk humans provide grounds for cautious optimism.

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Acknowledgments

This work was supported by the National Health and Medical Research Council of Australia (Program Grant 516700; Fellowship [LCH] 637301) and was made possible through Victorian State Government Operational Infrastructure Support and Australian Government NHMRC IRIIS.

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Conflict of Interest

Leonard C. Harrison, John M. Wentworth, Yuxia Zhang, Esther Bandala-Sanchez, Ralph M. Böhmer, Alana M. Neale, Natalie L. Stone, Gaetano Naselli, Julian J. Bosco, Priscilla Auyeung, Maryam Rashidi, Petra Augstein, and Grant Morahan declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Walter & Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, 3052, Victoria, Australia

    Leonard C. Harrison, John M. Wentworth, Yuxia Zhang, Esther Bandala-Sanchez, Ralph M. Böhmer, Alana M. Neale, Natalie L. Stone, Gaetano Naselli, Julian J. Bosco, Priscilla Auyeung, Maryam Rashidi, Petra Augstein & Grant Morahan

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Harrison, L.C., Wentworth, J.M., Zhang, Y. et al. Antigen-Based Vaccination and Prevention of Type 1 Diabetes. Curr Diab Rep 13, 616–623 (2013). https://doi.org/10.1007/s11892-013-0415-7

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