Immune Therapy Trial Points To Potential T1D Prevention
For twenty-five years medical researchers have been trying to treat type 1 diabetes (T1D) with immune therapy and failing. That may have finally changed last week.
In a clinical trial for a form of immunotherapy aimed at treating childhood food allergies, British scientists discovered the treatment in fact appeared to stop the immune system from attacking insulin production in those newly diagnosed with type 1 diabetes.
Researchers at King’s College London and Cardiff University tested the immunotherapy on 27 volunteers who had recently been diagnosed with T1D. The injectable treatment, called MonoPeptide, seeks to halt the progress of the autoimmune disease before it can destroy pancreatic beta cells that produce insulin.
During the 12-month long study, the eight volunteers received placebo injections required increasing levels of insulin to maintain their blood glucose levels (BGLs), a trend that follows the normal pattern of T1D. Their immune systems were simply continuing to destroy pancreatic cells that normally produce insulin naturally, a fate all-too-familiar to those with T1D.
On the other hand, the 19 subjects who received the actual immunotherapy injections continued to produce their own insulin. While the placebo group experienced about a 50 percent rise in daily insulin use, the treatment group saw no marked increase in insulin intake. The immunotherapy treatment, over the course of one year, essentially prevented their diabetes from attacking and destroying pancreatic beta cells, natural insulin production. All the volunteers were injected either every two or four weeks for six months. No adverse effects were reported from the immunotherapy injections.
Immunotherapies attempt to modulate a person’s immune system. They usually target autoimmune conditions such as multiple sclerosis, rheumatoid arthritis or lupus. T1D is also an autoimmune disorder. The T-cells in one’s immune system begin mistakenly attacking insulin-producing beta cells in the pancreas. MonoPeptide is a small protein fragment found in those beta cells called pro-insulin. The idea is that when MonoPeptide is introduced to a patient’s immune system, their immune system will no longer see it and will no longer identify pro-insulin as a foreign molecule to attack.
Researchers first noted the differing insulin trajectories in the two groups three months into the study. The trend continued. Experts said the discovery, if the treatment proves out in further trials, could one day free those with T1D from daily injections.
“We’re looking at a drug that could be usable in five to 10 years, if everything goes well,” said Mark Peakman, a professor at King’s College London who worked on the project.
The trial focused on newly diagnosed people with type 1 diabetes who still had about a fifth of their pancreatic beta cells remaining. While just retaining those remaining cells would make T1D easier to manage, the ultimate goal is prevention. In theory the drug would be given to children or young adults who start developing T1D. It could potentially be given to individuals with a high genetic T1D risk, researchers added.
The therapy is not likely to help those diagnosed with T1D years ago.
“At that stage,” said Peakman, “most of the beta cells have gone and we don’t find, with any therapies tried, any evidence of regeneration.”
This is an early-stage clinical trial, but the initial results are promising. For the first time, immunotherapy appears to be a potentially viable treatment option for combating and potentially halting T1D. The report was published last Wednesday in the journal Science Translational Medicine.
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