A new treatment being developed at the University of Cambridge may lead to an end to regular insulin injections that people suffering from diabetes are expected to endure.
The immune system of type 1 diabetics incorrectly identifies the insulin-producing cells of the pancreas as harmful and wages war against them until they are destroyed. As a consequence, there is a lack of required insulin to deliver glucose from the blood into cells. Without insulin, glucose levels in the blood rise uncontrolled, resulting in health problems: ergo the need for patients to inject themselves, several times a day, with insulin to compensate.
In a study released in the journal PLOS Medicine, researchers from the JDRF/Wellcome Trust Diabetes Inflammation Laboratory at the Cambridge Institute of Medical Research have utilized a drug to regulate the immune system preventing immune cells from attacking the insulin-producing cells originating in the pancreas.
The drug, known as aldesleukin, recombinant interleukin -2 (IL-2), has been employed at high doses to treat particular types of kidney tumors and cancers. However, at lower doses, aldesleukin enhances the capacity of regulatory T cells (Tregs) to put a halt to the immune system from damaging the body’s own organs (autoimmunity).
Researchers examined the effects of single doses of aldesleukin on Tregs as they relate to patients with type 1 diabetes. The technologically advanced trial used extensive immune monitoring in 40 participants with type 1 diabetes and recorded doses to increase Tregs by between 10-20%. At such levels doses are strong enough to prevent immune cells from attacking the body, but not strong enough to interfere with the body’s natural defences, which are essential for warding off infection, invading bacteria and viruses.
The researchers also found that the absence of response of some participants in previous trials may be explained by the daily dosing regimen of aldesleukin used. The current trial results suggest that daily dosing results in Tregs becoming less sensitive to the drug, and the recommendation from the study is that the drug should not be administered on a daily basis for optimal immune outcomes.
Dr Frank Waldron-Lynch, who led the trial said that his team’s work is still at an early stage, but it uses a drug that occurs naturally within the body to restore the immune system to health in these patients. “Whereas previous approaches have focused on suppressing the immune system, we are looking to fine-tune it. Our next step is to find the optimal, ‘Goldilocks’ treatment regimen – too little and it won’t stop the damage, too much and it could impair our natural defences, but just right and it would enhance the body’s own response.”
Currently, researchers are focusing their attention on people who are newly-diagnosed with type 1 diabetes, many of whom are still capable of producing enough insulin to prevent complications from the disease. The treatment, they hope will prevent further damage and help them to continue to produce insulin for a longer period of time.
