Diabetes vaccines: review of the clinical evidence

Author(s): Johnny Ludvigsson

As preservation of residual b-cell function is clinically important, such an effect constitutes clinical evidence. Traditional vaccination strengthening the immune reaction against an antigen/microbe may well be relevant for Type 1 diabetes (T1D) but progress takes time. Use of probiotics is another way of influencing the immune system at the border of ‘vaccination’. Methods of reducing a pathological-specific immune response, ‘inverse’ vaccination, are being developed. Use of insulin or its relatives (proinsulin and B-chain of insulin) is still experimental. Diapep277®, a heat shock protein, may modulate the immune system in a favorable way, and subcutaneous ‘vaccination’ with GAD-alum has shown encouraging results in T1D with recent onset. Perhaps autoantigens should be administered via DNA vaccines. It is possible that these will soon be part of clinical practice for the treatment of diabetes.