It may be possible to 'retrain' the immune system to slow the progression of type 1 diabetes, according to results of a clinical trial published today in the journal Science Translational Medicine.
Researchers leading the MonoPepT1De trial at King's College London and Cardiff University observed noticeable changes in the behaviour of the immune systems of type 1 diabetes patients that had been injected with peptides, small fragments of the protein molecules found in the beta cells of the pancreas.
Type 1 diabetes develops when a patient's immune system mistakenly attacks the insulin producing beta cells in the pancreas. Without treatment the number of beta cells will slowly decrease and the body will no longer be able to maintain normal blood sugar (blood glucose) levels.
The trial was led by Professor Mark Peakman, whose work is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at Guy's and St Thomas' NHS Foundation Trust and King's College London, and who says: "When someone is diagnosed with type 1 diabetes they still typically have between 15% and 20% of their beta cells. We wanted to see if we could protect these remaining cells by retraining the immune system to stop attacking them."
"We still have a long way to go, but these early results suggest we are heading in the right direction. The peptide technology used in our trial is not only appears to be safe for patients at this stage, but it also has a noticeable effect on the immune system."
There is currently no cure for type 1 diabetes, which can affect major organs in the body, including the heart, blood vessels, nerves, eyes and kidneys. The UK has one of the highest rates of type 1 diabetes in the world with 400,000 people currently living with the condition.
"It was encouraging to see that people who receive the treatment needed less insulin to control their blood glucose levels, suggesting that their pancreas was working better" commented, Prof Colin Dayan from Cardiff University, the clinical Chief Investigator for the study
The study was also supported by Diabetes UK and JDRF, the Type 1 diabetes charity.
Dr Elizabeth Robertson, Director of Research at Diabetes UK, the charity who supported the lead author of the study, said: "Diabetes UK is committed to increasing our understanding of the immune attack in type 1 diabetes and finding ways to stop it. These new findings are an exciting step towards immunotherapies being used to prevent this serious condition from developing in those at high risk, or stop it from progressing in those already diagnosed."
Karen Addington is UK Chief Executive of the type 1 diabetes charity JDRF which funded the research, said: "Exciting immunotherapy research like this increases the likelihood that one day insulin-producing cells can be protected and preserved. That would mean people at risk of Type 1 diabetes might one day need to take less insulin, and perhaps see a future where no one would ever face daily injections to stay alive."
Following the success of the MonoPepT1De trial, which was supported by the NIHR BRC at Guy's and St Thomas' and King's College London, King's and UCB Biopharma (a Belgian Biopharmaceutical company) are collaborating on a next generation product - MultipepT1De - in a Phase 1b safety study.
UCB has acquired exclusive licenses from King's College London to MonopepT1De and MultipepT1De worldwide.
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Note to editors:
* Professor Peakman and patient case study (see below) Kris Wood are happy to discuss this research.
Contact: Ben Sawtell, Communications Manager,
Research and Development Department at Guy's and St Thomas' NHS Foundation Trust incorporating the NIHR Biomedical Research Centre at Guy's and St Thomas' and King's College London
T: 020 7188 7604 | M: 07717 817 714
Patient case study
Kris Wood was an active 25 year old living and working in the North East of England when he noticed he began noticing dramatic shifts in his energy levels. He was rushed to Newcastle upon Tyne RVI A&E following alarming blood glucose results at an NHS walk-in centre, where we was diagnosed with type 1 diabetes.
"I was diagnosed with Type 1 diabetes on 23 March 2012," says Kris. "My very first reaction was disbelief. I am slim tall guy and play loads of sports - I was really active and it never occurred to me I would develop diabetes, there was no family history. It took a long while to adjust to the news, I just didn't know how to react."
Soon after he received his diagnosis Kris's consultant suggested he could take part in the MonoPepT1De trial which Newcastle Hospital had just begun recruiting for. He was initially keen, but members of his family were more cautious.
"I was determined to do anything I could to help me fight the condition, so taking part in the trial seemed like a great opportunity. Initially my family and friends were more cautious but I explained how safe these trials are and eventually they respected my decision to participate. So a few weeks later I was back in hospital for the first of many visits as part of the MonoPepT1De trial."
Since his diagnosis Kris has become an advocate for participation in clinical trials. He made a career change in 2014 and moved to London to work for the UK's leading type 1 diabetes charity, JDRF. He continued to participate in the trial at Guy's and St Thomas' NHS Foundation Trust, the lead centre.
"Being diagnosed with type 1 diabetes had changed my life in so many ways. I firmly believe that becoming involved in clinical trials has helped me to understand and manage my condition much better than I otherwise would have done. For me it was huge psychological boost to know I was taking extra measures to fight type 1 diabetes while potentially helping others at the same time."
About King's College London
King's College London is one of the top 25 universities in the world (2016/17 QS World University Rankings) and among the oldest in England. King's has more than 29,600 students (of whom nearly 11,700 are graduate students) from some 150 countries worldwide, and some 8,000 staff.
King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF), eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*).
Since our foundation, King's students and staff have dedicated themselves in the service of society. King's will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King's strategic vision for the next 12 years to 2029, which will be the 200th anniversary of the founding of the university. For further information about King's, please visit the King's in Brief web pages.
About the National Institute for Health Research (NIHR)
1. The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research.
Established by the Department of Health, the NIHR:
- funds high quality research to improve health
- trains and supports health researchers
- provides world-class research facilities
- works with the life sciences industry and charities to benefit all
- involves patients and the public at every step
For further information, visit the NIHR website http://www.nihr.ac.uk
2. All data represents clinical research studies supported by the NIHR Clinical Research Network (CRN). Data are sourced from the NIHR CRN Portfolio of studies. More information is available at: https://www.nihr.ac.uk/research-and-impact/nihr-clinical-research-network-portfolio/
3. These figures should not be cited as a count of people because a person may participate in more than one study.
4. Numbers over 1 million have been rounded to the nearest 100,000. Figures between 100,000 and 1 million have been rounded to the nearest 5,000. Percentages have been rounded to whole numbers.
5. In 2015-16, more than 605,000 participants were recruited into clinical research studies.
6. Results from the 2016-17 NIHR Research Activity League Table are available at https://www.nihr.ac.uk/research-and-impact/nhs-research-performance/league-tables/
Diabetes UK:
Diabetes UK's aim is creating a world where diabetes can do no harm. Diabetes is the most devastating and fastest growing health crisis of our time, affecting more people than any other serious health condition in the UK - more than dementia and cancer combined. There is currently no known cure for any type of diabetes. With the right treatment, knowledge and support people living with diabetes can lead a long, full and healthy life. For more information about diabetes and the charity's work, visit http://www.diabetes.org.uk
About UCB:
UCB, Brussels, Belgium (http://www.ucb.com) is a global biopharmaceutical company focused on the discovery and development of innovative medicines and solutions to transform the lives of people living with severe diseases of the immune system or of the central nervous system. With more than 7 500 people in approximately 40 countries, the company generated revenue of € 4.2 billion in 2016. UCB is listed on Euronext Brussels (symbol: UCB). Follow us on Twitter: @UCB_news
Journal
Science Translational Medicine