**14. Future perspectives of immune intervention**

No single therapy has shown to be an effective immune intervention in manifest Type 1 dia‐ betes for preservation of residual insulin secretion. As well as successful treatment of child‐ hood leukemia and cancers needed combination of several drugs, it will most probably be necessary to use combination therapies also for Type 1 diabetes. Auto-antigen treatment will probably be part of such future clinical treatment and/or prevention of Type 1 diabetes. Even though GAD-alum so far has not shown any stable efficacy, and Diapep 277 has shown slight efficacy only in adults with good C-peptide preservation, future studies will tell us how to use auto-antigen therapy more effectively, and then in combination with other therapiesIt may be so that treatment with GAD may be useful in patients with immune recognition of GAD, and treatment with proinsulin or insulin/insulin chains may be useful in patients whose immune system recognizes these auto-antigens. Furthermore, the effect might be improved by combi‐ nation therapies with eg Vitamin D, anti-inflammatory drugs, perhaps also in combinations with monoclonal antibodies. New ways of administration may be important and/or DNAvaccines may be found to be another effective way of creating tolerance against auto-antigens,. In spite of recent failures of some immune interventions in clinical trials knowledge is growing and there may soon be a breakthrough.
