And while we are at it, all of the other dread auto-immune diseases. Many of the therapies described below are only for Type 1 diabetes (T1D), but hacking the immune system, teaching T-cells not to attack specific body cell types, is extremely promising for every cell type involved, and every resulting disease.
Phosphatidyl Serine, shown diagrammatically in the image above, is a hacking key.
Molecular structure of PS and major biosynthetic and degradative pathways: PS is comprised of a glycerol backbone esterified at the sn-1 and sn-2 carbons of the glycerol moiety with two fatty acyl chains of variable length and saturation, as well as a phosphate linkage at the sn-3 position covalently linked to serine.
Any introductory textbook on biochemistry will explain that jargon, but you can see the chains on the left, the phosphorus and oxygen atoms joining pieces together, and the serine amino acid, with its NH3+ group.
Two processes for retraining the immune system are described below.
Type 1 Diabetes Cure: Current Research & Limitations (2023)
New Type 1 Diabetes Treatments
- Artificial Pancreas Systems: These devices combine continuous glucose monitoring with automated insulin delivery, essentially doing the job of a healthy pancreas. They can help individuals with T1D maintain tighter control over their blood sugar levels.
- Stem Cell Therapy involves using stem cells, particularly Mesenchymal Stem Cells (MSCs), to create new insulin-producing beta cells. This could restore the body’s ability to produce insulin, reducing or eliminating the need for insulin injections.
- Islet Cell Transplantation: This procedure involves transplanting islet cells containing insulin-producing beta cells from a donor into a person with T1D. This can help restore the body’s ability to produce insulin.
- Immunotherapies: These treatments aim to modulate the immune system’s response to prevent it from attacking the body’s own insulin-producing cells. This could potentially halt the progression of T1D.
- Glucagon-like peptide-1 (GLP-1) Receptor Agonists: These are a new class of drugs that can help the body produce more insulin and reduce glucose levels. They are currently used in Type 2 diabetes treatment but are being studied for use in T1D.
- Inhaled Insulin: This is a relatively new form of insulin delivery that can be inhaled through the mouth instead of injected. It offers a non-invasive alternative for insulin administration.
- Smart Insulin Pens: These devices track insulin doses and can transmit the data to a smartphone app, helping patients manage their condition more effectively.
- Closed-loop Insulin Delivery Systems: Also known as the “artificial pancreas,” these systems monitor blood glucose levels and automatically adjust insulin delivery, reducing the risk of high and low blood sugar levels.
- Beta Cell Encapsulation: This research involves encasing insulin-producing cells in a protective material that shields them from the immune system, potentially eliminating the need for immunosuppressive drugs after transplantation.
- Gene Therapy: While still in the experimental stages, gene therapy has the potential to reprogram other cells in the body to produce insulin, effectively replacing the function of the destroyed beta cells.
Ooooh, look! More Diary topics!
Immunotherapy
Immunotherapies are new treatments that reprogramme the immune system so that it no longer attacks and destroys insulin-producing cells in the pancreas. They’re being tested in clinical trials and could give us a way to stop type 1 diabetes in its tracks or prevent the condition entirely.
What is type 1 diabetes immunotherapy? | Diabetes UK
Medline Plus: Everything to Know About Autoimmune Diseases
A person may have more than one autoimmune disorder at the same time. Common autoimmune disorders include:
- Addison disease
- Celiac disease – sprue (gluten-sensitive enteropathy)
- Dermatomyositis
- Graves disease
- Hashimoto thyroiditis
- Inflammatory bowel disease (Crohn disease, ulcerative colitis)
- Multiple sclerosis
- Myasthenia gravis
- Pernicious anemia
- Reactive arthritis
- Rheumatoid arthritis
- Sjögren syndrome
- Systemic lupus erythematosus (lupus)
- Type I diabetes
Hacking the Immune System
Reverse vaccination technique in mice suggests new way to teach the immune system not to attack lifesaving treatments
A reverse vaccination approach my research team and I developed could train the immune system to ignore self-proteins and prevent unwanted immune responses.
The vaccine we developed uses one particular lipid molecule, phosphatidylserine. PS is typically located in the inner layer of a cell’s surface membrane. When a cell dies via apoptosis, a natural process the body uses to remove damaged cells, PS becomes exposed to the outside of that cell. Upon exposure, PS sends an “eat me” signal that recruits specialized cells to clear up leftover debris from the now-dead cell.
Our team had previously found that high levels of PS outside the cell also actively teach the immune system to ignore the exposed debris. So we wondered if PS could be used to help the immune system learn not to attack specific proteins.
We tested our concept on mice with hemophilia A. People with this genetic condition are unable to make the blood-clotting protein factor VIII. Although typical treatment involves administering factor VIII directly to patients to prevent uncontrollable bleeding, about a third develop an immune response against this protein after repeated exposure.
When we reverse-vaccinated the mice with factor VIII paired with an optimized form of PS, however, 75% of the mice did not develop an unwanted immune response when they were later reexposed to factor VIII over the course of four weeks. This meant that the immune system was able to learn that factor VIII was not harmful and remembered to tolerate it.
Promising, although 75% in mice with hemophilia is not the answer for us specifically. But how about this?
‘Inverse vaccine’ shows potential to treat multiple sclerosis, other autoimmune diseases
A new type of vaccine developed by researchers at the University of Chicago’s Pritzker School of Molecular Engineering has shown that it can reverse autoimmune diseases like multiple sclerosis and type 1 diabetes in lab tests — all without shutting down the rest of the immune system.
They discovered in recent years that tagging molecules with a sugar known as N-acetylgalactosamine (pGal) could mimic this process, sending the molecules to the liver where tolerance to them develops.
First person seemingly cured of type 1 diabetes
The first participant, who is 64, has been living with Type 1 diabetes for nearly 50 years. His disease is so severe, he regularly experienced sudden drops in blood sugar that caused him to lose consciousness. A few days after receiving an infusion of stem cells that have been “taught” how to behave like islets, everything changed. His blood sugar readings were in the normal range. Even after eating a meal, which requires the body to secrete insulin in order to manage blood glucose, his readings remained perfect.
If this first participant continues to respond to ongoing treatment, his will be the first-ever functional cure of diabetes. It’s a thrilling — but also very early — result. There are 16 more participants in the clinical trial, and five years left to go.
I have lost consciousness from low blood sugar once. It was enough.
FDA approves first cellular therapy for type 1 diabetes: What does it do?
In 2021, about 8.4 million people globally had type 1 diabetes.
In late June 2023, the Food and Drug Administration (FDA) approvedTrusted Source a new therapy for type 1 diabetes called LantidraTrusted Source — the first allogeneic pancreatic islet cellular therapyTrusted Source made from deceased donor pancreatic cells.
Two safety and efficacy studies found that 21 participants who took Lantidra did not need to administer themselves insulin for a year or more. Twelve of those participants did not need to take insulin for up to 5 years, and 9 did not need insulin for over 5 years.
Reversing Diabetic Complications
There is evidence to suggest that diabetes complications can be reversed if strong diabetes control and a healthy lifestyle are followed. Control of blood glucose levels can lead to diabetic complications development slowing down or even regressed in some cases.
This includes kidney and other organ damage. I will be interested to follow work on reversing diabetic neuropathy and eye damage, not just slowing it down or preventing it.
Trials, Anyone?
Complete this online screening form to determine your candidacy for our IRB-approved mesenchymal stem cell (MSC) infusion at DVC Stem in Grand Cayman. This is the first step of our onboarding process.
Is There a Cure for Type 1 Diabetes?
Now clinical trials are underway for treatments to reverse type 1 diabetes and restore the body’s ability to produce insulin naturally. These trials are already allowing some patients to live insulin-free, significantly improving their quality of life.
DRI researchers are working toward a biological cure for type 1 diabetes. A biological cure means treatment that would help the body start producing its own insulin again, restoring blood sugars to normal levels without introducing other risks. This research focuses on a process called islet transplantation.
DRI scientists have a number of clinical trials currently underway, including an islet transplant study that is testing the omentum as an alternative transplant site to the liver. Other ongoing clinical trials include the POSEIDON Trial, which tests whether high doses of vitamin D and Omega-3 fatty acids can help slow or stop the progression of type 1 diabetes in newly diagnosed children and adults.