INS and type 1 diabetes mellitus: Phase I/IIa trials (2009–2014) showed the approach was safe without immunosuppression and led to improved glucose control and reduced insulin requirements in some T1D patients (169). Efficacy was variable and not curative. No zoonoses or serious reactions observed. Further Phase I/IIa trials are planned in 2024 under Otsuka (Japan) to test refined protocols.