Immunometabolic biomarkers for partial remission in type 1 diabetes mellitus.

The natural history of type 1 diabetes mellitus (T1DM) is dynamic and nonlinear, presenting episodes of relapsing and remitting autoimmunity. Immunometabolism regulation can transiently restore β cell function, causing an episode of partial remission (PR), also known as the honeymoon phase. During this transient period, the residual β cell mass shows an improved function, contributing to better glycemic control. Several mechanisms by which PR arises are reflected in the periphery as biomarkers, including changes in immune cell subsets and molecules, demonstrating that immune modulation can improve endogenous insulin secretion. Predictive models of remission on T1DM diagnosis may have clinical implications for patient stratification in immune intervention clinical trials and more personalized therapeutic management. Shortly after diagnosis of type 1 diabetes mellitus (T1DM) and initiation of insulin therapy, many patients experience a transient partial remission (PR) phase, also known as the honeymoon phase. This phase presents a potential therapeutic opportunity due to its association with immunoregulatory and β cell-protective mechanisms. However, the lack of biomarkers makes its characterization difficult. In this review, we cover the current literature addressing the discovery of new predictive and monitoring biomarkers that contribute to the understanding of the metabolic, epigenetic, and immunological mechanisms underlying PR. We further discuss how these peripheral biomarkers reflect attempts to arrest β cell autoimmunity and how these can be applied in clinical practice. [ABSTRACT FROM AUTHOR]