Epitope-based precision immunotherapy of Type 1 diabetes

Antigen-specific immunotherapies (ASITs) address important clinical needs in treating autoimmune diseases. However, Type 1 diabetes is a heterogeneous disease wherein patient characteristics influence responsiveness to ASITs. Targeting not only disease-relevant T cell populations, but also specific groups of patients using precision medicine is a new goal toward achieving effective treatment. HLA-restricted peptides provide advantages over protein as antigens, however, methods for profiling antigen-specific T cells need to improve in sensitivity, depth, and throughput to facilitate epitope selection. Delivery approaches are highly diverse, illustrating the many ways relevant antigen-presenting cell populations and anatomical locations can be targeted for tolerance induction. The role of persistence of antigen presentation in promoting durable antigen-specific tolerance requires further investigation. Based on the outcome of ASIT trials, the field is moving toward using patient-specific variations to improve efficacy, but challenges still lie on the path to delivering more effective and safer treatment to the T1D patient population.

Automated summary

Antigen-specific immunotherapies (ASITs) are important in treating autoimmune diseases, but their effectiveness is influenced by patient characteristics in Type 1 diabetes. Precision medicine targeting specific T cell populations and patient subgroups is a new goal. Profiling methods for antigen-specific T cells need improvement, as well as delivery approaches for tolerance induction. The field is moving toward using patient-specific variations to improve efficacy, but challenges remain.