Diabetes intervention therapy.

The involvement of autoreactive T cells in autoimmune diseases suggests the potential for intervention therapy in the setting of insulin-dependent diabetes mellitus. In the nonobese diabetic mouse, diabetes and insulitis have been inhibited by the modification of an amino acid in the major histocompatibility complex and by administration of anti-I-A antibody. T-cell vaccination has been shown to prevent autoimmune disease in animal models, and research is ongoing to develop monoclonal antibodies to a variety of T-cell receptor components. Strategies assessed in the clinical context include the administration of azathioprine, cyclosporine, and the antioxidant nicotinamide. Other potential strategies include the induction of specific oral tolerance, insulin prophylaxis, immunoenhancement therapy, and dietary manipulation.