Reference : L'etude clinique du mois. Essais de preservation des cellules B a la phase initiale d...
Scientific journals : Article
Human health sciences : Endocrinology, metabolism & nutrition
L'etude clinique du mois. Essais de preservation des cellules B a la phase initiale du diabete de type 1: resultats negatifs avec l'insuline retard, mais prometteurs avec un anticorps monoclonal anti-CD3.
[en] Clinical study of the month. Attempt at preservation of B cells during the initial phase of type 1 diabetes: negative results with ultralente insulin, but promising results with an anti-CD3 monoclonal antibody
Philips, Jean-Christophe mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]
Scheen, André mailto [Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]
Revue Médicale de Liège
Yes (verified by ORBi)
[en] Adult ; Antibodies, Monoclonal/therapeutic use ; Antigens, CD3/immunology ; Diabetes Mellitus, Type 1/prevention & control ; Disease Progression ; Genetic Predisposition to Disease ; Humans ; Hypoglycemic Agents/administration & dosage/pharmacology ; Injections, Subcutaneous ; Insulin, Long-Acting/administration & dosage/pharmacology ; Islets of Langerhans/cytology/pathology ; Randomized Controlled Trials as Topic ; Risk Factors
[en] Type 1 diabetes is an autoimmune disease leading to a progressive exhaustion of the insulin secretion and a destruction of the B-cells. Attempts of preservation of insulin-producing B-cells can be performed at an early, most often silent, stage of the disease in well-selected at high risk subjects or during the period immediately following the clinical diagnosis based upon classical signs of hyperglycaemia. In the "Diabetes Prevention Trial-Type 1", the prophylactic subcutaneous administration of low-dose ultralente insulin was not able to prevent the development of type 1 diabetes nor to preserve residual insulin secretion in young relatives at very high-risk of diabetes, selected upon genetic, immunological and metabolic criteria. In contrast, a pilot randomized trial shows that a treatment with a nonactivating humanized monoclonal antibody against CD3 mitigates the deterioration in insulin production and improves metabolic control, with lower dose of exogenous insulin, during the first year of type 1 diabetes mellitus in 9 out of 12 treated patients. Besides a better understanding of the natural history of the disease, these clinical trials open new perspectives for prevention of type 1 diabetes mellitus, currently assessed by the Belgian Diabetes Registry.
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