Transforming Growth Factor Beta-Based Therapies, a Potential Modulator of the Immune Response in Type 1 Diabetes?

Immunobiological interventions are proving to be an exciting new area for mobilising the immune response towards certain tumours. In contrast, classical immunotherapeutic interventions aimed at dampening the autoimmune response to host tissue have been less successful; this is particularly evident for Type 1 diabetes (T1D). In part, the failure to control autoimmunity in T1D relates to the complexity of the immune response to β cells. To resolve this dilemma, immunologists are turning to immunobiological agents that were initially deemed too high risk for therapeutic use due to their potential to inadvertently promote autoimmunity or induce deleterious side effects. Two of these immunobiological mediators under consideration are transforming growth factor β (TGFβ) and tolerogenic dendritic cells (DCs), both of which have shown robust control of the anti-islet response in animal models of T1D, the latter also recently documented to be acceptable for trialling in patients with T1D. In this review, both the challenges of translating immunobiological therapies discovered in animal models of T1D to man and the potential of TGFβ and tolerogenic DCs in the T1D setting will be discussed.