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| ID | Type | Description | Link |
|---|---|---|---|
| ISRCTN27852285 | Registry Identifier | ISRCTN |
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| Name | Class |
|---|---|
| University of Cambridge | OTHER |
| Juvenile Diabetes Research Foundation | OTHER |
| National Institute for Health Research, United Kingdom | OTHER_GOV |
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Type 1 diabetes is the most common severe chronic autoimmune disease worldwide and is caused by the autoimmune (loss of self tolerance) mediated destruction of the insulin producing pancreatic beta cells thus leading to insulin deficiency and development of hyperglycaemia. Currently, medical management of type 1 diabetes focuses on intensive insulin replacement therapy to limit complications (retinopathy, nephropathy, neuropathy); nevertheless clinical outcomes remain sub optimal. There are intensive efforts to design novel immunotherapies that can arrest the autoimmune process and thereby preserve residual insulin production leading to fewer complications and better clinical outcomes.
The vast majority of genes that contribute to susceptibility to type 1 diabetes have been found to encode proteins involved in immune regulation and function. In particular, several susceptibility proteins are involved in the interleukin 2 (IL-2) pathway that regulates T cell activation and tolerance to self antigens. Aldesleukin is a human recombinant IL-2 product produced by recombinant DNA technology using genetically engineered E. coli stain containing an analog of the human interleukin-2 gene. There is substantial nonclinical, preclinical and clinical data that ultra low dose IL-2 (aldesleukin) therapy can arrest the autoimmune mediated destruction of pancreatic beta cells by induction of functional T regulatory cells. However, prior to embarking on large proof of concept trials in type 1 diabetes it is essential that the optimum dose of IL-2 (aldesleukin) is determined. The objective of this study is to establish in patients with type 1 diabetes the optimal dose of IL-2 (aldesleukin) to administer in order to increase T regulatory cell response.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aldesleukin (Proleukin) | Drug | A single, subcutaneous dose will be given administered with the maximum dose allowed 1.5 X 106 IU/M2. |
| Measure | Description | Time Frame |
|---|---|---|
| The primary endpoint is based upon the percentage of CD4+T regulatory (defined as CD3+CD4+CD25highCD127low) cells within the CD3+CD4+T cell gate following treatment with IL-2. | Fluorescence-activated cell sorting assay | From Day 0 to Day 60 |
| Measure | Description | Time Frame |
|---|---|---|
| T regulatory cell phenotype and stability | Fluorescence-activated cell sorting assay | From Day 0 to Day 60 |
| T effector cell number and phenotype | Fluorescence-activated cell sorting assay |
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Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Frank Waldron-Lynch | University of Cambridge | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wellcome Trust Clinical Research Facility, Addenbrooke's Hospital | Cambridge | CB2 0QQ | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24898091 | Background | Waldron-Lynch F, Kareclas P, Irons K, Walker NM, Mander A, Wicker LS, Todd JA, Bond S. Rationale and study design of the Adaptive study of IL-2 dose on regulatory T cells in type 1 diabetes (DILT1D): a non-randomised, open label, adaptive dose finding trial. BMJ Open. 2014 Jun 4;4(6):e005559. doi: 10.1136/bmjopen-2014-005559. | |
| 25881192 |
| Label | URL |
|---|---|
| DILT1D trial facebook page | View source |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Sep 22, 2016 | |
| Reset | Nov 9, 2016 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 22, 2016 | Nov 9, 2016 |
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| C082598 | aldesleukin |
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| Wellcome Trust |
| OTHER |
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| From Day 0 - Day 60 |
| T cell subset proliferation and populations | Fluorescence-activated cell sorting assay | From Day 0 - Day 60 |
| Intracellular T cell and natural killer(NK) cell signalling | Fluorescence-activated cell sorting assay | From Day 0 - Day 60 |
| T regulatory cell function | T suppression assay | From Day 0 - Day 60 |
| IL-2 pathway genotype | DNA sequencing | From Day 0 - Day 60 |
| Lymphocyte Subsets | Complete blood count | From Day 0 to Day 60 |
| Serum Cytokines | Enzyme-linked immuno sorbent assay | From Day 0 to Day 60 |
| Glycaemic control | Self monitoring blood glucose readings, HbA1c, insulin usage | From Day 0 to Day 60 |
| Number of Participants with Adverse Events as a Measure of Safety and Tolerability | From Day O to Day 60 |
| Heywood J, Evangelou M, Goymer D, Kennet J, Anselmiova K, Guy C, O'Brien C, Nutland S, Brown J, Walker NM, Todd JA, Waldron-Lynch F. Effective recruitment of participants to a phase I study using the internet and publicity releases through charities and patient organisations: analysis of the adaptive study of IL-2 dose on regulatory T cells in type 1 diabetes (DILT1D). Trials. 2015 Mar 11;16:86. doi: 10.1186/s13063-015-0583-7. |
| 27727279 | Derived | Todd JA, Evangelou M, Cutler AJ, Pekalski ML, Walker NM, Stevens HE, Porter L, Smyth DJ, Rainbow DB, Ferreira RC, Esposito L, Hunter KM, Loudon K, Irons K, Yang JH, Bell CJ, Schuilenburg H, Heywood J, Challis B, Neupane S, Clarke P, Coleman G, Dawson S, Goymer D, Anselmiova K, Kennet J, Brown J, Caddy SL, Lu J, Greatorex J, Goodfellow I, Wallace C, Tree TI, Evans M, Mander AP, Bond S, Wicker LS, Waldron-Lynch F. Regulatory T Cell Responses in Participants with Type 1 Diabetes after a Single Dose of Interleukin-2: A Non-Randomised, Open Label, Adaptive Dose-Finding Trial. PLoS Med. 2016 Oct 11;13(10):e1002139. doi: 10.1371/journal.pmed.1002139. eCollection 2016 Oct. |
| DILT1D trial Twitter update | View source |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |