teplizumab therapy for type 1 diabetes mellitus

Last edited 11/2022 and last reviewed 12/2022

Teplizumab therapy for type 1 diabetes mellitus

Teplizumab is a monoclonal antibody that binds to CD3 molecules on the surface of CD4+ and CD8+ T cells, both involved in the destruction of pancreatic beta cells

  • Fc receptor-nonbinding anti-CD3 monoclonal antibodies such as Teplizumab have been studied in patients with T1DM
    • teplizumab is an Fc receptor-nonbinding anti-CD3 episilon monoclonal antibody

  • Herold et al showed that a single course of teplizumab significantly slowed progression to clinical type 1 diabetes in high-risk, nondiabetic relativestives of patients with diabetes who had at least two autoantibodies and abnormal results of an oral glucose-tolerance test at trial entry (1)

  • studies have detected an increase in C-peptide levels in early-onset type 1 diabetes patients treated with teplizumab
    • this suggests that teplizumab leads to an improvement in beta cell function (2,3)

Reference:

  1. Herold KC, Bundy BN, Long SA, Bluestone JA, DiMeglio LA, Dufort MJ, Gitelman SE, Gottlieb PA, Krischer JP, Linsley PS, Marks JB, Moore W, Moran A, Rodriguez H, Russell WE, Schatz D, Skyler JS, Tsalikian E, Wherrett DK, Ziegler AG, Greenbaum CJ; Type 1 Diabetes TrialNet Study Group. An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med. 2019 Aug 15;381(7):603-613
  2. Sims EK, Bundy BN, Stier K, Serti E, Lim N, Long SA, Geyer SM, Moran A, Greenbaum CJ, Evans-Molina C, Herold KC: Teplizumab improves and stabilizes beta cell funSmigoc Schweiger D: Recent Advances in Immune-based Therapies for Type 1 Diabetes. Horm Res Paediatr. 2022 May 9. doi: 10.1159/000524866ction in antibody-positive high-risk individuals. Sci Transl Med. 2021 Mar 3;13(583):eabc8980
  3. Smigoc Schweiger D: Recent Advances in Immune-based Therapies for Type 1 Diabetes. Horm Res Paediatr. 2022 May 9. doi: 10.1159/000524866