PERSPECTIVES ON THE USE OF ANTI-CD20 IMMUNOTHERAPY IN THE TREATMENT OF TYPE 1 DIABETES MELLITUS IN CHILDREN AND ADOLESCENTS (ANALYTICAL REVIEW)

Type 1 diabetes mellitus (DM1) is a world- and widespread disease in children and adolescents caused by the destruction of insulin-producing β-cells in the pancreas. As of today there is only one generally accepted approach to treating DM1, which is the insulin therapy, which in fact is a symptomatic therapy since it is aimed at correcting the outcome of the DM1 pathogenesis through compensation of insulin deficiency and elimination of hyperglycemia. The insulin therapy makes it possible to maintain the acceptable blood glucose levels for decades, but does not prevent the development of severe chronic complications of DM1, which in its turn are the main causes for disability cases and early deaths in such patients. Practitioners and scientists in diabetology are therefore actively searching for the ways to treating DM1 etiologically and pathogenetically. Among such methods there are various promising variants of immunotherapy aimed at prevention or suppression of an autoimmune reaction against β-cells. This review provides the basic information on DM1 and considers the modern approaches to its immunotherapy. The particular attention is paid to immunotherapy using cytotoxic monoclonal antibodies against B-lymphocytes autoreactive towards β-cells.