In a groundbreaking moment for Italian medicine, the University Hospital of Palermo has successfully administered Teplizumab — a monoclonal antibody capable of delaying the clinical onset of Type 1 diabetes — to a 22-year-old patient. This marks the first use of the drug in Italy, a milestone achieved in a region seldom recognized for medical firsts.
The administration was overseen by Professor Giorgio Arnaldi, a renowned endocrinologist from the Marche region, who has headed Palermo’s Unit of Endocrine, Metabolic, and Nutrition Diseases for the past 18 months.
A New Frontier for Diabetes Prevention
Type 1 diabetes is an autoimmune disease, triggered by genetic predisposition and external factors such as viral infections,” explained Arnaldi. “T lymphocytes attack the pancreas, leading to insulin deficiency. Teplizumab, a humanized monoclonal antibody, intervenes by modulating the activity of T cells through the CD3 molecule, reprogramming them to prevent further damage to the pancreas.”
Arnaldi emphasized that the treatment targets patients at a critical stage — before clinical symptoms emerge. “Type 1 diabetes progresses through three stages: first, the appearance of autoantibodies; second, prediabetes, with metabolic alterations but no symptoms; and finally, clinical diabetes requiring insulin. Teplizumab acts at the second stage, blocking the progression to full disease.”
Careful Selection and Team Excellence
Identifying the right patient was a delicate process requiring sharp clinical judgment. Professor Valentina Guarnotta led the effort, overseeing the selection of the young woman who received the therapy. Arnaldi credited the success to the dedication of the entire medical and nursing teams, and expressed gratitude for the support provided by the hospital administration.
Eligibility and Future Applications
Teplizumab is approved for patients aged eight and older and can only be administered in centers with proven clinical excellence.
While southern Italy is not typically seen as a hub for pioneering medical treatments, Arnaldi challenged this stereotype. “I don’t think geographically. Palermo’s center has a deep tradition in treating Type 1 diabetes, and this achievement reflects the talent, intuition, and patient-centered care of our team,” he said. He also noted that other southern institutions, like Naples’ Federico II Polyclinic, have built strong reputations.
Leading the Way in Europe
Although Teplizumab has seen limited use in Europe — with cases reported in France and Germany — Palermo’s University Hospital is the first in Italy to administer it, setting a precedent for the country.
Treatment Protocol and Patient Experience
The treatment involves 14 consecutive days of intravenous infusions, with gradually increasing doses. Side effects have been minimal, limited mainly to a temporary reduction in white blood cells. Arnaldi emphasized that the drug is the result of 30 years of research, and further studies are underway to explore repeated treatment cycles.
A Message Beyond Medicine
“This experience shows that clinical excellence depends not on geography, but on culture, empathy, and listening,” Arnaldi reflected. “Medicine is not just a technical discipline — it’s about timing, perception, and trust. While Teplizumab is not a cure, it offers a real opportunity to delay the progression of diabetes. Success depends on attentive eyes and skilled hands.”
As for the patient relationship, Arnaldi stressed its critical role: “Building human connections transforms scientific innovation into real care. Trust and transparency make even the most daunting treatments possible.”
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