Cellular immunotherapy for type 1 diabetes mellitus
The cause of the development and progression of type 1 diabetes mellitus (T1DM) is an autoimmune process in which the altered immune system destroys the patient’s own β-cells responsible for the production of insulin. As a result of insulin deficiency, persistent dysregulation of carbohydrate metabolism occurs. However, it is possible to protect β-cells from destruction if the aggressive reaction of the immune system is stopped.
Dendritic cells (DCs) are a key regulator of immune responses in humans. They are the most powerful antigen-presenting cells and can both initiate and inhibit immune activity. In particular, tolerogenic dendritic cells (tDCs) have immunosuppressive properties, leading the immune system to an anti-inflammatory state that is tolerant of self-antigens. Specially prepared tolDCs are able to suppress the autoimmune reaction against β-cells in patients with T1DM.
Cell therapy for T1DM is based on the use of the patient’s own tolDCs, programmed to inhibit the autoimmune reaction against β-cells. As a result of such therapy, the number of autoantibodies to β-cell antigens and the activity of autoantigen-specific T cells in the patient’s body decreases, which means that the survival of β-cells increases and their insulin-producing ability is restored. In addition, other inflammatory processes associated with T1DM are reduced.
The clinical effect of a course of cell therapy is manifested by stabilization of the course of diabetes (lack of disease progression according to laboratory results) and a decrease in the daily dose of insulin. The maximum clinical effect can be expected with constant courses of cell therapy under the control of the content of autoantigen-specific T cells and (or) autoantibodies to β-cell antigens in the peripheral blood. Cell therapy has an important effect on the prevention of complications of T1DM, significantly reducing the risk of target organ damage: kidneys, cardiovascular system, and retina. However, one cannot count on a complete cure.
The biomaterial for obtaining immature DCs is peripheral venous blood. The production stage takes up to 10 days. The finished BMCP containing tolDC, programmed to inhibit the autoimmune reaction against pancreatic β-cells, is administered to the patient subcutaneously. The use of BMCP based on autologous (i.e., one’s own) tolDCs is well tolerated by the patient and is completely safe, does not cause allergic or toxic reactions, does not suppress the immune system in general and does not stimulate the development of tumors.
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