Possible Pharmacotherapeutic Effects of Immunomodulators in the Treatment of Diabetes Mellitus

This review article demonstrates the possible therapeutic effects of immunomodulators on diabetes mellitus. Multiple molecular mechanisms, including autoimmunity, inflammation and metabolic stress, are risk factors for the development of β-cell deficiency. Against the background of oökthe inflammatory process in adipocytes, the immune response is enhanced by apoptosis and macrophage infiltration, the interaction of the pathogenic factor with CD4+ and CD8+ T cells, and CD11c+ M1 macrophages in adipose tissue enhance the inflammatory process in adipose tissue and peripheral insulin resistance. Immunomodulatory pharmacotherapeutic approaches are designed to disrupt the proinflammatory process through various mechanisms, including the ability to modulate the immune system's response to diseases, the action of antioxidants, disruption of bacterial flora, monoclonal antibodies, cytokines and extracellular immune mediators, as well as extracellular immune signals. Studies by North American and French scientists have shown that the use of monoclonal anti-CD3 antibodies can block both the destructive autoimmune process and, at least, delay the decline in beta-cell function. Rituximab (anti-CD20) reduces HbA1c and normalizes insulin secretion, thereby providing a therapeutic effect in patients with diabetes mellitus. Interleukins (IL) are potent immunomodulators that have a significant effect on the immune system, exerting cytostatic, pronecrotic and proapoptotic inhibitory effects, which is very important given the pathogenesis of diabetes mellitus. The purpose of the study is to identify additional therapeutic options for pharmacological correction of diabetes. As a result of the listed scientific analysis, the use of immunomodulators can be considered appropriate for the purpose of pharmacological correction of both types of diabetes.