Immunologic "vaccination" for the prevention of autoimune diabetes (type 1A)

Diabetes type 1A is an autoimmune condition characterized by lymphocytic in filtration of islets and selective destruction of insulin-secreting beta-ce lls. Numerous investigators have prevented diabetes in animal models with a variety oi antigens and routes of administration. It is also now possible to identify high-risk individuals even before the appearance of autoantibod ies. These advances have created the opportunity to design and begin human prevention trials. This review focuses on a variety of immunomodulatory app roaches (including administration of adjuvants, autoantigens, T-cells, T-ce ll receptors, and DNA) that ive have collectively termed immunologic "vacci nation." In addition, we discuss the potential benefits and dangers of thes e approaches and issues relating to the design of human trials.