New research demonstrates that delivery of engineered therapeutic dendritic cells that target lymphoid sites of tolerance induction can compensate for failing tolerance in the patient.
Self-recognition and tolerance are essential aspects of normal immune system function and general health. Failures in this role of immunosurveillance can result in a wide range of autoimmune diseases. For example, the proper regulation of insulin, a metabolic hormone produced by beta-cells on pancreatic islets of Langerhans, is compromised in Type 1 diabetes (T1D). In a previous blog, we discussed cellular therapy of Type 2 diabetes and here we shed light on the cause and approaches to treat T1D.
The development of T1D results from a failure to recognize beta-cell antigens as “self” and the resulting destruction of the beta-cells by one’s own immune system.
University of South Carolina School of Medicine)
Tolerogenesis requires a homeostatic balance involving the deletion, anergy or suppression of self-reactive T cells. Popular strategies for treating T1D include preventing the destruction of beta-cells or inducing their regeneration. One particular approach involves personalized therapy with tolerogenic antigen-presenting cells (APCs). New research suggests that the cell type known as dendritic cells, derived from stem cells via the myeloid branch of the cellular immune system, could play a critical role in the treatment of T1D as a cellular immunotherapy. 
The new study has shown that delivery of engineered therapeutic dendritic cells that target lymphoid sites of tolerance induction can compensate for failing tolerance in the patient and stimulate existing or new regulatory cell populations.
Cellular therapy with dendritic cells offers many advantages. Readily generated from blood, their migratory pathways from sites of inoculation to target tissues allow interactions with lymph-borne antigens and reduce or eliminate the need to provide exogenous antigens, a quality that helps compensate for epitope spread.
Dendritic cells also lend themselves well to in vitro manipulation and can regulate the activity and durability of other immunoregulatory cells. In so doing, they increase the probability that multiple layers of tolerance can be built and maintained for long-lasting immunoregulation and prevent the progression to clinical hyperglycemia. Of course safety is the cornerstone of any new therapy and the clinical safety of dendritic cells has been demonstrated in phase I clinical trials.
HemaCare is a leading player in biological blood products and also supplies myeloid derived dendritic cells as part of their line of products for research and development of novel immunotherapies including for the treatment of transplantation rejection.
 Creusot RJ, Giannoukakis N, Trucco M, Clare-Salzler MJ, Fathman CG. It's time to bring dendritic cell therapy to type 1 diabetes. Diabetes. 2014 Jan;63(1):20-30. doi: 10.2337/db13-0886.