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The battle to tame autoimmunity

A more tolerant immune system could alleviate, or even prevent, autoimmune disorders such as type 1 diabetes and multiple sclerosis, as well as the rejection of transplanted organs.

There is no cure for type 1 diabetes. Instead, the condition, in which a person’s immune system destroys their ability to produce the glucose-regulating hormone insulin, must be carefully managed. But even the most vigilant of those affected will experience organ-damaging bouts of high blood-sugar levels, and will be at an increased risk of cardiovascular disease, nerve damage and blindness.

Immunologists suggest that it doesn’t have to be that way. In August 2017, Mark Peakman, a clinical immunologist at King’s College London, and his colleagues published the results of an early clinical trial of a treatment that aims to teach the immune systems of people with type 1 diabetes to spare the insulin-producing cells of the pancreas1. The study was designed to assess the safety of the treatment in those who have been newly diagnosed with the disease, but it also showed hints of efficacy, says Peakman. Six months after their initial diagnosis, most of the treated participants were still producing enough insulin to avoid the need to increase their use of synthetic insulin, unlike those who received a placebo. The researchers are now planning a phase II clinical trial.

[…]Researchers also anticipate that the growing number of people with cancer who are treated with immunotherapy will further increase the prevalence of autoimmunity. Such treatments deliberately unleash the immune system to fight tumours, but they can also trigger autoimmune diseases, including rheumatoid arthritis and colitis. In May 2017, researchers at the University of California, San Francisco, and the nearby Parker Institute for Cancer Immunotherapy, proposed that these unintended consequences have become “the Achilles’ heel of immunotherapy.”

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