Use of a cocktail regimen consisting of soluble galectin-1, rapamycin and histone deacetylase inhibitor may effectively prevent type 1 diabetes.

Type 1 diabetes (T1D) is an autoimmune disorder that results in destruction of insulin-releasing beta-cells of the pancreas. During the pathogenesis of T1D, at least two phases of beta-cell death occur: an initiation event wherein macrophage-derived inflammatory cytokines induce beta-cell necrosis and release of beta-cell-specific antigens, and a second, antigen-driven event in which T-cell-mediated immune response is directed against beta-cells. In contrast to macrophages and autoreactive T cells, regulatory T cells play a key role in inducing and maintaining immunological tolerance to self antigens. Therefore, modulation of the immune system may prevent the development of T1D. Herein, we proposed a cocktail regimen consisting of soluble galectin-1, rapamycin and histone deacetylase inhibitor (HDACi) for the treatment of T1D because (a) HDACi has been reported to protect against IL-1beta-mediated loss in beta-cell viability, (b) HDACi and rapamycin have the ability to promote the generation and function of regulatory T cells and thus suppress the cytotoxic T-cell function, and (c) administration of soluble galectin-1 can trigger apoptosis of the beta-cell-reactive T cells. This cocktail regimen may not only block T-cell- and cytokine-mediated autoimmunity but also restore self-tolerance to beta-cell antigens, therefore representing a novel alternative for treatment of T1D.