Intervention at neonatal age: can we intervene?

Abstract

108COMMENTARIES -IDS ery systems such as coupling to non-toxic cholera toxin subunits, oral and nasal routes, transgenic edible plants, and lactating mice that secrete GAD in the breast milk.One hurdle we face is the modification of a therapy designed for a certain population to the general public. While susceptible individuals can be identified through HLA-DR/DQ typing and autoantibody detection in first degree relatives of diagnosed diabetics, it is a challenge to extend this screening to the general population. Additionally, there are other issues we face. While we can attribute 50% of the total genetic risk for IDD to the HLA region on chromosome 6, unknown environmental factors also play a major role in disease susceptibility. A child born in Finland is 400 times more likely to develop IDD than a child born in China. Is it possible to design one universal vaccine, or will we need different vaccines for different regions of the world? Finally, we place our faith in animals such as the NOD mouse as models of human diabetes; yet, we must consider that animal immunotherapies may not extend readily to humans.With little knowledge of how the immune system fights foreign pathogens, Jenner succeeded in designing a pox vaccine. As we move forward, his success should inspire us in our fight against autoimmune pathologies as well. There are clearly many challenges ahead of us, but the creation of a childhood diabetes vaccine is within our power.