Cure for T1D closer than ever before

Recently, scientists from Harvard University and MIT have shown that it is possible to ‘cure’ diabetes for long periods of time without the need for pancreatic islet transplants.

This novel ‘cure’ is based on a method for mass-producing insulin-secreting beta cells discovered by Harvard University in 2014, but has only now been tested on animals. When these cells were transplanted into mice, it was found that the disease ‘switched off’ for 6 months, which if implemented into humans could potentially delay diabetes for several years.

With this breakthrough, daily insulin injections could become but a distant memory for the 400,000 or so type 1 diabetics in the UK, finally giving them the freedom to eat what they want without constantly worrying about their blood sugar levels.

However, it is likely that it will take several years for human trials to take place, and will be even longer for the therapy to be implemented outside of clinical trials. Still, it is encouraging to see that progress is being made in realising a cure for diabetes mellitus.

 

Sources:  Harvard and MIT close to ‘cure’ for Type 1 diabetes which will end daily injections

Cure for Type 1 diabetes imminent after Harvard stem-cell breakthrough; both from telegraph.co.uk, by Sarah Knapton

Re-creating Pancreas Cells

From nothing to a fully functioning pancreas. For most diabetics this is but a distant dream- while some may be able to get a pancreatic islet transplant, the closest the majority of people suffering diabetes mellitus will get to independence from their condition is an insulin pump.

However, a team from the Diabetes Research Institute in Miami Florida found that bone proteins “used to help bones mend” can also force cells in the pancreas to produce insulin, instead of the missing beta cells that typically make this hormone in non-diabetics. What this will mean for diabetics like me, is that they will not have to do regular injections as to keep their blood sugar levels in check, just like non-diabetics.

In this form of therapy, non-beta cells in the pancreas are exposed to “a growth factor called BMP-7” that transforms them into insulin-producing cells. This method was tested on diabetic mice whose “beta cells had been destroyed artificially with a chemical”, and the therapy led to these cells behaving just like healthy insulin-producing beta cells. However, this has not yet been tested on humans, so it is yet to be seen if it will work. Nonetheless, it is very encouraging to see that a great variety of potential cures are being developed to combat this condition which blights approximately 40 million people worldwide.

 

Source: Diabetic pancreas cells made to produce insulin by bone protein from newscientist.co.uk, by Andy Coghlan.

 

Tackling Diabetes Mellitus with T-reg Cells

As anyone who has diabetes type 1 knows all too well,  this disease, as manageable as it is, requires almost constant attention, which can at times be tiring. One person that understands this very well is child psychologist Mary Rooney, who was only diagnosed in 2011 with diabetes mellitus, and recently had groundbreaking therapy which she said had “freed her from the daily grind” of managing her condition.

This new therapy developed by researchers at the University of California and Yale involves taking “peacekeeping” T-reg cells that “protect insulin-making cells from the immune system” from patients, replicating them in a growth medium and finally infusing them back into the blood. In the initial trial  of 14 people carried out by these researchers, it was found that the “the therapy is safe, and can last up to a year”, showing that it is possible to turn back the clock on the body destroying its own insulin-secreting cells in the pancreas. Moreover, this therapy could be used in combination with “an independent source of insulin producing cells” to completely control the condition, according to Professor Bluestone from the University of California.

Finally, this latest development in finding a cure for diabetes mellitus could also lead to cures for other autoimmune diseases such as “rheumatoid arthritis and lupus”, and could possibly even help cure neurological diseases.

 

Source: End of daily injections for diabetes as scientists restore insulin production from telegraph.co.uk, by Sara Knapton

Pancreatic Cells ‘Rebooted’ To Produce Insulin

Last week a team from the Catholic University of Louvain (UCL) in Belgium reported their findings on a novel way of potentially curing diabetes that involves taking pancreatic cells and genetically modifying them as to coerce them into secreting insulin, thus countering the loss of insulin production typically seen in diabetics.

The method involves taking “pancreatic duct cells from dead donors”, which “don’t normally produce insulin”, but can “differentiate into specific cell types”. This feature has been harnessed by this team as to produce insulin by adding a “genetic switch” to change their behaviour. These cells were then implanted into diabetic mice, and were found to produce insulin.

However, this cure is still in early development, and we will have to see if these cells can be used in humans as well.

Source: New Scientist, edition no. 3042, ‘In Brief’ section- ‘Reboot insulin cells to treat diabetes’

Bacteria Tackle Diabetes

A team has recently engineered a bacterium to make intestinal cells behave like pancreatic cells, causing them to produce insulin and consequently decrease blood sugar levels. In the latest study, rats where fed this chemical, and it was found to trigger certain cells in the gut to behave like pancreatic cells. Moreover, this bacterium, which can be found in some probiotic yoghurts, does not have to be injected to work properly and it could even potentially be taken in the form of a pill; also it has not been shown to affect the cells’ normal functions, meaning it should be absolutely safe to use.

This cure appears to have potential, and it would be marvellous if it could become the cure for type 1 diabetes. However, at this moment it has only been shown to “replace ∼25–33% of the insulin capacity of non-diabetic healthy rats”, and it is still in development so it may take many years for this to be widely available.

Sources:

New Scientist, edition no. 3008, ’60 Seconds’ section- ‘Bugs tackle diabetes’

Diabetes Journals – http://diabetes.diabetesjournals.org/content/early/2015/01/27/db14-0635#corresp-1

The Bionic Pancreas

While there are many potential permanent cures for diabetes type 1, some scientists are developing better ways of controlling the blood sugar levels in diabetic patients. Ed Diamano, a biomedical engineer whose son was diagnosed with type 1 diabetes at the age of 11 months, has created “a digital pancreas that automatically regulates sugar levels in the blood via a smartphone”. The user has a glucose monitor underneath their skin, which measures the glucose levels every 5 minutes and sends a signal to an iPhone app that calculates the amount of insulin that is required to balance the blood sugar. The app then sends a signal to insulin pumps carried by the diabetic to administer the dose via a catheter. While this system cannot cure diabetes, it can give diabetics a rest from keeping their blood glucose levels in check and can give them a glimpse of a life without diabetes.

Moreover, this system has been tested out on both adults and young people: in one study, 20 adults wore the device for five days in a hotel, while in another study thirty-two young people, aged between 12 and 20, tested the device at a camp for diabetic children for five days, and the device performed incredibly well in controlling the participants’ blood sugar levels.

Overall, I believe that this new device might be a good solution for people with type 1 diabetes while they are waiting for a permanent cure.

Nanoscience and Diabetes

Nanotechnology has advanced significantly in the past decade, and research is now being conducted to see if it could be used in the field of biomedicine. According to recent research, nanoscience could be applied to the monitoring of bodily functions as well as delivering drugs to organs in tiny capsules; this could be used to monitor blood sugar levels, or help the pancreases of type 1 diabetics to regain the ability to produce insulin.

The group of researchers from MIT and Carnegie Mellon University showed that glucose nanosensors could be incorporated in devices that could be implanted into the body, allowing patients to monitor their blood sugar levels in real-time. One material which is being considered for the nanosensors is glucose oxidase. These are “glucose‑binding proteins and glucose‑binding small molecules” which react  “to enzymatically convert glucose into D‑glucono‑δ‑lactone (which hydrolyses into gluconic acid) and hydrogen peroxide”: this results in an electrical current, proportional to the amount of sugar in the blood, thus allowing a transducer to send this data to a device that can interpret the blood sugar from these readings. These molecules have been attached onto the “surface of metallic nanoparticles, including… gold and platinum nanoparticles, as well as carbon nanotubes”. Moreover, nanosensors based on carbon nanotubes using “the binding of glucose to the sensor to provide a fluorescent or voltammetric readout” “have demonstrated remarkable longevity. For example, carbon nanotubes… remained functional for more than 400 days when implanted… into mice”.

Furthermore, nanoparticles have been used to help increase insulin secretion. “The gene encoding glucagon‑like peptide 1 has been delivered via nanoparticles” to boost the production of insulin and increase the viability of transplant islets (to find out more about islet transplants, click here).

Although the use of nanotechnology for controlling and monitoring diabetes is very recent, I hope that this research will continue for many years and will lead to great advances in the search for the cure for diabetes.

Source: http://www.nature.com/nrd/journal/v14/n1/full/nrd4477.html

Canine Heroes

For people with brittle diabetes type 1, so named because of the sudden fluctuations in blood sugar levels, life can be very difficult: one second you may be feeling fine, but within minutes your blood sugar can drop dramatically, possibly leaving you comatose. For 12 year-old Steven, his four-year-old cocker spaniel, Molly, was a life saver- she was trained to smell changes that occur as a result of changes in blood sugar levels in his breath, so that she could notify him by barking and become agitated when he was at risk of getting hypoglycaemia. Moreover, before getting Molly, Steven’s parents barely slept due to the constant blood sugar levels checks in the night, for fear of him getting a hypoglycaemic attack.

Although dogs have been used for helping people with many other diseases and conditions, they have also proven to be effective at detecting certain ailments; some dogs can detect cancer in people, and it is very likely that our canine friends can also detect a wide variety of other conditions, and possibly even diabetes. This could help substantially with early diagnosis of diabetes, but also with helping people with brittle diabetes, like Steven, for whom it is incredibly hard to maintain good blood sugar levels.  At the moment, the main group leading the training and research of medical assistance dogs  is Medical Assistance Dogs, a charity that aims to train dogs to help people with any diseases or conditions, and to train dogs to detect cancer. However, due to the lack of funding their progress has been slowed down considerably; if you would like to donate to this charity, then visit their donation page on their website, where you can find out more information about their life-saving work.

Source: Telegraph magazine, 6th December 2014, article  ‘Pet rescue’

The Faustman Lab

Over the past decade, Denise Faustman, the Director of the Immunobiology Laboratory at the Massachusetts General Hospital (MGH) and her team have been researching a new way of curing type 1 diabetes involving the 90-year-old vaccine Bacillus Calmette-Guerin (BCG).  Altough BCG was originally used to combat tuberculosis, the team at the MGH found out that BCG increased levels of TNF (a signaling protein involved in the body’s immune responses), which could eliminate defective T cells “that mistakenly attack and destroy the insulin-producing cells of the pancreas”. The Phase 1 trials on diabetics showed that the vaccine BCG decreased the number of defective T cells, that the vaccine did not cause any major complications in the diabetics and that “in people living with diabetes for an average of 15 years, there was a transient increase in restoration of pancreatic insulin secretion after BCG vaccination.”

This prospective cure shows a lot of promise, although the Phase 2 trials will determine the true long-term potential of this method in humans; in the Phase 1 trial only a “transient increase” in insulin production was noticed in the diabetics. Furthermore, for the Phase 2 trial to take place the Faustman Lab requires approximately $6.8 million more in funding: you can donate by going to their website, where you can also find out more about their ground-breaking work.

Sources: http://www.faustmanlab.org/index.html and http://www.faustmanlab.org/docs/clinicalt/BCG%20TRIALS%20FACT%20SHEET.pdf

Guiding the Immune System

For many years it has been believed that we have very little control over our immune systems. However, recently, a group of volunteers led by Dutchman Wim Hof (famous for holding numerous world records for withstanding extreme cold), as mentioned in the New Scientist magazine in the article ‘Just chilling out’ (23rd of August 2014, issue no. 2983), have appeared to prove this widely held belief wrong.

Hof taught 12 volunteers several techniques that would help them to tolerate extreme cold, including meditation, repeated exposure to cold and breathing techniques involving hyperventilation and then holding one’s breath. Afterwards, the volunteers’ immune systems were tested using a model devised by the Radboud University Medical Centre in the Netherlands: the volunteers were injected “with a substance called endotoxin (found in the cell walls of bacteria), which tricks the immune system into reacting as if there are bacteria in the bloodstream that need to be eradicated. In response to this ‘infection’, the body mounts an immune response, producing signalling molecules called cytokines”.

Despite the fact that usually people experience flu-like symptoms and fever after being injected with endotoxins, “the volunteers trained by Hof, who practised the breathing techniques during the experiment, … reported fewer flu-like symptoms, experienced lower fevers and had cytokine levels of less than half of the control group.” This shows that it is possible to influence our immune system, although being able to undo the damage inflicted by autoimmune diseases by attempting to control your immune system appears to be a long way away.

Nonetheless, it is very interesting to see that the immune system can almost be guided voluntarily, and I hope that some time in the future this could become one potential method for curing autoimmune diseases, including diabetes type 1.