GAD65: a prospective vaccine for treating Type 1 diabetes?

ABSTRACT

Introduction: In spite of modern techniques, the burden for patients with type 1 diabetes (T1D) will not disappear and T1D remains a life-threatening disease causing severe complications and increased mortality. We have to learn how to preserve residual insulin secretion or even increase beta cell regeneration. This would give a milder disease, simpler treatment and perhaps even cure. Thus, there are good reasons to try therapies that may preserve beta cell function.

Areas covered: In this review the author reviews the literature and registered ongoing trials using GAD-alum put in relation to the high number of published different immune interventions.

Expert opinion: GAD-alum treatment is safe, tolerable and easy for the patients and healthcare. It seems probable that treatment with GAD65-alum 20 µg sc can preserve residual beta cell function in T1D, but efficacy needs to be improved. This may be achieved by the use of combination therapies and new approaches for administration.

KEYWORDS:

• GAD65-alum
• Type 1 diabetes
• immune intervention
• prevention
• combination therapy
• intra-lymphatic treatment
• children

Acknowledgments

In addition to the author the Linköping Diabetes Immune Intervention study group consists of Ass.Professor Rosaura Casas, a number of postdoctoral researchers (currently Hugo Barcenilla, Beatriz Tavira Iglesias) and PhD students including Linda Åkerman. We are grateful to excellent technical assistance from Ingela Johansson and Gosia Smolinska, and from research diabetes nurses Eva Isacson, Annmarie Sandström, Anette Nilsson and Sofia Sjöberg.

Declaration of interest

J Ludvigsson has received honorarium for lectures from NovoNordisk, Eli Lilly and Company and Sanofi Aventis, and as a member of advisory Boards of NovoNordisk, Pfizer Inc, Janssen Pharmaceuticals, LifeScan and DebioPharm during certain periods. He has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

The studies have been generously funded by The Swedish Child Diabetes Foundation (Barndiabetesfonden), Juvenile Diabetes Research Foundation, The Research Council of Southeast Sweden (FORSS), and Diabetesfonden (Swedish Diabetes Association). Diamyd Medical sponsored the Phase II/III GAD trials and has also given unrestricted financial support for the investigator-initiated mechanistic studies connected to these trials.