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C19-A3 proinsulin peptide coupled to gold nanoparticles (Midacore) is an investigational antigen-specific immunotherapy designed for the treatment of type 1 diabetes mellitus. Developed by Cardiff University in collaboration with Midatech Pharma (now Biodexa Pharmaceuticals), the therapeutic consists of an 18-amino acid human proinsulin peptide (C19-A3) spanning residues from position 19 of the C-peptide to position 3 of the A-chain. This peptide is covalently coupled via a thiol linker to ultrasmall gold nanoparticles (GNPs) of less than 5 nm in size. The drug is administered intradermally using a microneedle delivery system (MicronJet600) to target skin-resident antigen-presenting cells, particularly Langerhans cells. These cells process and present the proinsulin autoantigen to HLA-DR4-restricted T cells, aiming to induce immune tolerance and halt the autoimmune destruction of pancreatic beta-cells. Gold nanoparticles serve as a delivery platform to enhance peptide uptake and potentially provide anti-inflammatory properties.
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