Immunological studies for prevention and treatment of insulin-dependent diabetes mellitus in childhood

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It is well established that autoimmune mechanisms are involved in the development of insulindependent diabetes mellitus(IDDM) but there are at present no immunological ways to treat IDDM. This study was aimed to elucidate the autoimmune mechanisms in IDDM and search for possible immunotherapies agaist IDDM.IDDM of Japanese was found to be associated with HIA as is IDDM of Caucasians; an autoimmune type of IDDM was associated with HLA-DRw9 and a non-autoimmune type of IDDM with HLA-DR4. ICA was detected with a high frequency in both types of IDDM at the early period although the duration of ICA differed between two types of IDDM. These findings indicate that HLA and ICA are useful to predict the development of IDDM in children who have a family history of IDDM or who are positive for urinary glucose at the screening at school. HLA is particularly useful to find an autoimmune type of IDDM agaist which the applications of immunotherapies might be possible.In order to search for immunotherapies agaist IDDM, cyclosporin and B-1,3 D-glucan were studied in animal models of IDDM, NOD mice and BB rats. These immunosuppressor and immunomodulator were found to suppress the insulitis and overt diabetes of these animals. Furthermore, dietary composition was shown to be involved in the prevention of overt diabetes in NOD mice. These findings suggest that the immunotherapies combined with dietary therapies might be possible ways to prevent or treat IDDM. Further studies on the immunological mechanisms underlying IDDM lead to the development of better immunotherapies agaist IDDM.