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Proinsulin peptide C19-A3 (PPI C19-A3) is an investigational, antigen-specific peptide immunotherapy developed by Cardiff University in collaboration with King's College London for the treatment of newly diagnosed type 1 diabetes mellitus. The drug consists of an 18-amino acid synthetic peptide (GSLQPLALEGSLQKRGIV) spanning from position 19 of the C-peptide of proinsulin to position 3 of the A-chain. It is designed to target the HLA-DR4 (HLA-DRB1*0401)-restricted T cell response to proinsulin, aiming to restore immune tolerance and halt the autoimmune destruction of pancreatic beta cells. Administered via intradermal injection, PPI C19-A3 has been evaluated in a Phase 1b clinical trial (MonoPepT1De) where it demonstrated safety, tolerability, and signs of beta-cell preservation. A gold nanoparticle-coupled formulation (C19-A3 GNP) has also been developed to enhance its tolerogenic potential.
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