GAD-alum (Diamyd) – a new concept for preservation of residual insulin secretion

Abstract

Importance of the field: Type 1 diabetes is a common and very serious disease. There has been very active research going on for a long time aiming at preservation of the residual insulin secretion by some kind of intervention to stop the destructive autoimmune process. This review covers a new type of immune intervention using auto-antigen treatment.

Areas covered in this review: Immune interventions in type 1 diabetes have been tried during the last 30 years, this review mentions some of them, but the main topic is the use of the auto-antigen glutamic acid decarboxylase (GAD) to create tolerance to stop the autoimmune process. The clinical trials have been performed during the last 15 years and are all covered.

What the reader will gain: This review will give the reader a picture of the research behind treatment with GAD as an immune intervention in type 1 diabetes.

Take home message: The key finding so far is that treatment with Diamyd^® has not only been shown to preserve residual beta cell function in type 1 diabetes, but this treatment may be the proof in humans of a new concept of treating and perhaps even preventing autoimmune diseases.

Keywords::

• Diamyd
• GAD
• GADA
• immune intervention
• prevention
• type 1 diabetes

Acknowledgements

This article was written on behalf of the Linköping Diabetes Immune Intervention Study Group (Johnny Ludvigsson MD, PhD, Rosaura Casas PhD, Stina Axelssom, Mikael Cheramy, Maria Hjorth and Mikael Pihl). The GAD-vaccination studies have been possible thanks to several collaborators at the Division of Pediatrics and Diabetes Research Centre, Linköping University, and I want to especially thank, in addition to the Linköping Immune Intervention Study Group, M Faresjö, a former participant in the group, the technicians L Berglert, I Johansson, G Smolinska and E Widegren the research nurses E Isacson and AM Sandström, the physicians BM Holmqvist and U Samuelsson and all pediatricians and nurses involved at different Swedish pediatric clinics. I am also very grateful for a good collaboration with Diamyd Medical AB, not least A Essen-Möller, E Hillborg, E Lindner and P Zerhouni.