Study Vaccination to Prevent Type 1 Diabetes?

In the future, a preventive insulin vaccine may be used to prevent type 1 diabetes. Scientists at the DFG Center for Regenerative Therapies at the Dresden University of Technology (CRTD) and the Institute for Diabetes Research at Helmholtz Zentrum München, together with researchers from Vienna, Bristol and Denver, have successfully "taken the first step towards a preventive insulin vaccine against type 1 diabetes" According to the CRTD communication.

The evaluations of the international Pre-POINT study showed that the oral intake of insulin induces a positive immune response in the case of at-risk persons, without causing side effects such as hypoglycaemia, say diabetes researchers in the current issue of the renowned journal "Journal of the American Medical Association "(JAMA). Further studies should now investigate "whether an insulin vaccine can permanently prevent the onset of the disease."

Prevent autoimmune disease with insulin vaccine?
Patients with type 1 diabetes have had to inject insulin several times a day throughout their lives. In the course of the autoimmune disease, the insulin-producing beta cells in the pancreas of those affected are usually destroyed in childhood by the body's immune system, explain the scientists. The autoimmune reaction is triggered by antigens, such as the insulin itself, which are mistakenly classified by the organism as "foreign bodies" and fought. Normally the immune system builds an immune tolerance against the body's own proteins during the first years of life, so that it does not come to an autoimmune reaction and additionally cells are provided, which prevent the destruction of the own cells, so the message of the CRTD. A corresponding positive immune response, the scientists hope to produce using the insulin vaccine. Here, the international research team has now taken the first step.

Positive immune response without side effects
In the Pre-POINT study, children with a high disease risk for type 1 diabetes were treated with oral insulin once daily in Germany, Austria, the United States and the United Kingdom for an average of half a year, while the control group received only an ineffective placebo , Over the course of the study, the drug-taking group was taking insulin as a powder along with the diet. At the highest dose (67.5 mg), the insulin powder finally elicited the desired immune response, reports the CRTD. There were no adverse events, suggesting that "we have successfully mimicked the normal processes in the body of a healthy child who prevent type 1 diabetes," said study leader Professor Ezio Bonifacio from the Center for Regenerative Therapies. "We suspect that the major part of the immune response to insulin already occurs in the mouth," continues Bonifacio. Because the insulin in the chosen form of administration is already broken down in the stomach, it has no influence on the blood sugar level.

Prophylactic administration of insulin
According to Prof. Anette-Gabriele Ziegler from the Institute for Diabetes Research, another unique feature of the current study is that insulin was prophylactically administered as a vaccine at a time when the children have not yet developed an autoimmune reaction - that is, no autoantibodies had. So the children were vaccinated against diabetes. "This is a revolution in the treatment of type 1 diabetes," explains Prof. Ziegler. But the procedure is only logical. "If the immune system does not learn the protective immune response by itself, the medicine just has to give a little tuition," said the expert. In subsequent studies, a larger number of babies, the type 1 diabetes risk genes and diseased relatives and thus have a high risk of disease should be treated with insulin, the researchers report. With the help of the vaccine, the autoimmune disease can be prevented permanently, the way would be clear for a comprehensive preventive vaccine, so the conclusion of the scientists. (Fp)

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Picture credits: Michael Horn