期刊
JCI INSIGHT
卷 6, 期 21, 页码 -出版社
AMER SOC CLINICAL INVESTIGATION INC
DOI: 10.1172/jci.insight.150074
关键词
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资金
- NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- National Institute of Allergy and Infectious Diseases (NIAID) from NIH/National Center for Research Resources (NCRR) Clinical and Translational Science Award (CTSA) [UM1AI109565, UL1TR000004]
- NIH/NIDDK [P30DK036836, U01DK103266, U01-DK085476]
- NIH/NCRR CTSA [1UL1TR000064]
- NIH/National Center for Advancing Translational Sciences (NCATS) from NIH/CTSA [UL1TR001878, UL1TR002537]
- National Health and Medical Research Council Practitioner Fellowship [APP1136735]
- NIH/CTSA [UL1-TR002494, UL1TR003142]
- Indiana Clinical and Translational Science Institute Award [UL1TR002529]
- Vanderbilt Institute for Clinical and Translational Research [UL1TR000445]
- Veteran Affairs Administration [1R01AI132774]
The study found that tocilizumab did not slow the loss of residual beta cell function in newly diagnosed type 1 diabetes patients, despite reducing T cell IL-6R signaling. Additionally, there were no changes observed in CD4(+)T cell phenotypes.
BACKGROUND. IL-6 receptor (IL-6R) signaling drives development of T cell populations important to type 1 diabetes pathogenesis. We evaluated whether blockade of IL-6R with monoclonal antibody tocilizumab would slow loss of residual beta cell function in newly diagnosed type 1 diabetes patients. METHODS. We conducted a multicenter, randomized, placebo-controlled, double-blind trial with tocilizumab in new-onset type 1 diabetes. Participants were screened within 100 days of diagnosis. Eligible participants were randomized 2:1 to receive 7 monthly doses of tocilizumab or placebo. The primary outcome was the change from screening in the mean AUC of C-peptide collected duringthe first 2 hours of a mixed meal tolerance test at week 52 in pediatric participants (ages 6-17years). RESULTS. There was no statistical difference in the primary outcome between tocilizumab and placebo. Immunophenotyping showed reductions in downstream signaling of the IL-6R in T cells but no changes in CD4 memory subsets, Th17 cells, Tregs, or CD4(+) T effector cell resistance to Treg suppression. A DC subset decreased during therapy but regressed to baseline once therapy stopped. Tocilizumab was well tolerated. CONCLUSION. Tocilizumab reduced T cell IL-6R signaling but did not modulate CD4(+)T cell phenotypes or slow loss of residual beta cell function in newly diagnosed individuals with type 1 diabetes.
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