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One of the most promising immune interventions in type 1 diabetes is using antibodies against CD3, a marker on T lymphocytes. I’ve already shown you the effects of teplizumab in newly diagnosed people with type 1 diabetes. Here, I’ll show you the effects of teplizumab in people with a high risk of type 1 diabetes. It studied in 44 individuals, the effect of teplizumab on arresting the progression from antibody positivity and dysglycemia to overt type 1 diabetes, and compared the administration of teplizumab in these 44 people to 32 individuals who received placebo. Of course, this study was done in a double blind fashion. It was performed in individuals between 12 and 22 years of age, adolescents and young adults, who were all first degree relatives of people with type 1 diabetes or even more distant relatives. But they all needed to have antibodies against at least one antigen in the beta cell, and show signs in their glycaemic profile of being on their way to type 1 diabetes. When you look at the figure, you see the delay in progression to overt type 1 diabetes in those individuals who receive teplizumab compared to placebo. This was measured by the area under the curve of C-peptide after a mixed meal tolerance test. You will see that the people who receive teplizumab had a more than two year delay in their diagnosis of type 1 diabetes and, thus, in needing insulin. In table 2 you see the side effects of the treatment. If you treat individuals with an antibody against CD3, a surface marker on T lymphocytes, you do expect the disappearance of these cells, and thus, abnormalities in the blood count. Now, these abnormalities are transient. Of importance is that there were no severe adverse events. There was some pain, especially joint pain, some fever at the time of administration, but these side effects were quite limited.
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