11 August, 2017
Type 1 diabetes develops when a patient's immune system mistakenly attacks the insulin producing beta cells in the pancreas. The authors say further investigations that include larger cohorts will be required to evaluate efficacy, but the favorable safety profile they observed suggests immunotherapy could be a viable option for treating type 1 diabetes. The new immune therapy they have developed is made to distract the T cells of the immune system that normally destroy the beta cells of the pancreas. However, those in the placebo arm needed to increase their insulin doses over the one-year period.
The report of the early-stage clinical trial, published Wednesday in the journal Science Translational Medicine, offers some preliminary reassurance that immunotherapy could be used safely in this growing population.
Damaged immune cells of type 1 diabetics can be "retrained" to slow the progression of the condition, experts believe.
This resulted in "noticeable changes" in the behaviour of the immune system, according to the researchers.
By using just a piece of the antigen that typically causes the immune reaction, the approach of such "peptide immunotherapy" aims to inure the immune system to the object of attack while avoiding a full-on allergic response. "We wanted to see if we could protect these remaining cells by retraining the immune system to stop attacking them", said lead researcher Mark Peakman and King's College London professor in a university statement. A fragment of the chemical that gives rise to insulin, the peptide (known to chemists by the catchy moniker GSLQPLALEGSLQKRGIV) is called an epitope. Patients were randomized into one of three groups: one group received immunotherapy every two weeks; a second group received immunotherapy every four weeks; and a third group received placebo. As many as 1.25 million Americans are living with type 1 diabetes, and the autoimmune disorder's prevalence has been increasing in recent decades, with roughly 40,000 people diagnosed each year.
The researchers said the therapy, which is similar to an allergy shot in the manner it works, can keep people with type-1 diabetes safe.
Some 27 people were involved in the latest trial, which involved giving some patients fortnightly or monthly injections for six months. The study's recruits were all at a stage of the disorder when the pancreas' insulin-producing cells were still at least partly intact and capable of producing the hormone in response to food intake.
Type 1 diabetes afflicts some 400,000 people in the United Kingdom, one of the highest rates in the world. Type 1 diabetes is now considered to be incurable.