Pathways to Stop Type 1 Diabetes: A Look Forward

This content originally appeared on Diatribe. It was reissued with permission.

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In a search for type 1 diabetes treatments, scientists are experimenting with how to design beta cells to withstand immune system attacks. During the 83rd Science Session of the American Diabetes Association in San Diego, experts shared their early research results and where they were on the road to stopping type 1 diabetes.

Researchers, advocates, and patients have long searched for treatments for type 1 diabetes, a chronic autoimmune condition in which the immune system destroys insulin-producing beta cells in the pancreas.

Currently, the closest treatments to treatment are pancreatic transplants or beta cells from the deceased. Both options come with key caveats, including a limited number of pancreatic organ donors, how complicated it is to protect a transplanted beta cell, and the need for long-term immunosuppressive drugs.

“To get to the true control of glucose a patient needs, we need to find a treatment,” said Judith Agudo, principal investigator at the Dana-Farber Cancer Institute. “And true treatment comes from retrieving what is missing – the missing betacells.”

Agudo was one of the few experts who spoke during the ADA science session and shared that he was working to stop type 1 diabetes by cracking beta cell codes and other pathways.

Engineering Super Powerful Beta Cell

In type 1 diabetes, the immune system identifies beta cells as foreign bodies. This attacks T cells (which usually help protect the body from infection). One strategy to address this is to take medications that lower the body’s immune response.

The problem here is that suppressing the immune system makes you more vulnerable to infections and cancer in the body. Long-term immunosuppression is additional risks for diabetics, as people with diabetes are already at a higher risk of developing infections and cancer.

Agudo has been studying model T cells, which she called Jedi T cells. This allows you to study the immune system’s attacks against beta cells. Through her research, she realized that many cells were targeted by Jedi T cells, but some could survive.

“We learn from nature from cells that can escape immune attacks,” she said. “This indicates that they are healthy insulin-producing beta cells dealing with strong T-cell attacks.”

The mechanism behind why some beta cells can resist the onslaught of T cells is unknown, but Agudo revealed this, saying that scientists can manipulate super-strong beta cells that can be implanted into patients and survive without the need for drugs that compromise the immune system.

Cloaking Beta Cell

Another problem is protecting the implanted cells. T cells identify and attack implanted cells in the same way as the original cells. So how do you keep new cells safe?

Agudo explained that one choice hides them. One strategy is called encapsulation, and provides a physical barrier to the implanted cells from reaching immune cells. The downside here is that the barriers make the exchange of nutrients and oxygen harder and prevent cells from entering the blood.

Other studies suggest “immune cloaking” strategies in which islands are designed to be hidden or recognized by immune cells that target them as foreign bodies.

“They can no longer see, hide in blind places and survive now,” Agudo said.

Uses intestinal bacteria as a vaccine

Evidence from the studies suggests that the gut microbiota is an important component in the development of type 1 diabetes.

Alexander Costick, an assistant professor of microbiology at Harvard Medical School and investigator at the Jocelyn Diabetes Center, discussed research into the development of vaccines for type 1 diabetes using microbial antigens (invasion of microorganisms or foreign substances).

Existing research supports the idea of ​​vaccines against viruses living in the gastrointestinal tract, such as Cox Sacchivilas B, which is thought to be a factor in the development of type 1 diabetes. Recent animal studies are also being investigated Salmonella– A based vaccine to prevent and reverse diabetes. Kostic’s research focuses on vaccinating against another microbial antigen called polyN-acetylglucosamine, which could lead to protection against the condition.

“We started developing this as a treatment for type 1 diabetes,” says Kostic. “We are discovering that vaccinations with this antigen can stop diabetes in mice.”

Researchers like Kostic and Agudo are part of the ADA’s pathway to stop diabetes programs, providing scientists with grants and resources to accelerate and transform diabetes research.

“It may sound like science fiction, but it’s not, it’s happening,” Agdo said. “We’re the first, and that’s a really exciting moment.”