Article
Author: Dayan, C ; Levin, Y ; von Ruhland, C ; Alhadj Ali, M ; Rodríguez Terradillos, K ; Dul, M ; Barry, J ; Birchall, J C ; Ludvigsson, J ; Casas, R ; Wong, F S ; May, K ; Kochba, E ; Cheung, W Y ; Stenson, R ; Barrientos, A ; Coulman, S A ; Howell, A ; Ingram, J R ; Dunseath, G ; Chowdhury, M M U ; McAteer, M A ; Holland, G ; Luzio, S D ; Perera, I ; Tatovic, D
Abstract:Antigen-specific immunotherapy is an immunomodulatory strategy for autoimmune diseases, such as type 1 diabetes, in which patients are treated with autoantigens to promote immune tolerance, stop autoimmune β-cell destruction and prevent permanent dependence on exogenous insulin. In this study, human proinsulin peptide C19-A3 (known for its positive safety profile) was conjugated to ultrasmall gold nanoparticles (GNPs), an attractive drug delivery platform due to the potential anti-inflammatory properties of gold. We hypothesised that microneedle intradermal delivery of C19-A3 GNP may improve peptide pharmacokinetics and induce tolerogenic immunomodulation and proceeded to evaluate its safety and feasibility in a first-in-human trial. Allowing for the limitation of the small number of participants, intradermal administration of C19-A3 GNP appears safe and well tolerated in participants with type 1 diabetes. The associated prolonged skin retention of C19-A3 GNP after intradermal administration offers a number of possibilities to enhance its tolerogenic potential, which should be explored in future studies