Type 1 diabetes therapy beyond T cell targeting: monocytes, B cells, and innate lymphocytes
F. Susan Wong1 and Li Wen2
1 Institute of Molecular and Experimental Medicine, Cardiff School of Medicine, Cardiff
University, Heath Park, Cardiff CF14 4XN, UK
2 Section of Endocrinology, Department of Medicine, Yale School of Medicine, 333
Cedar Street, New Haven CT 06520, USA
Abstract
Recent clinical trials in Type 1 diabetes have mainly focused 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 Type 1 diabetes 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 Type 1 diabetes is a multifactorial disease, in which it is known that 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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