Will type 1 diabetes be curable in the future?

Immune response in type 1 diabetes successfully stopped

Type 1 diabetes usually occurs in childhood and is caused by an excessive immune response, in which the insulin-producing cells of the pancreas are eliminated. Scientists at the Helmholtz Zentrum München have now discovered a way to suppress the immune response and thus prevent the onset of autoimmune diseases.

The researchers at Helmholtz Zentrum München reported that they identified a mechanism "that enhances the autoimmune response in early-onset type 1 diabetes," and that if the molecules were blocked, the immune system was significantly less active. The onset of autoimmune diseases could therefore be prevented with early intervention. The scientists published their study results in the journal "Science Translational Medicine".

In type 1 diabetes so far no cure is possible and sufferers must life-long control their blood sugar. However, the development of autoimmune disease could possibly be stopped early in the future. (Image: Kwangmoo / fotolia.com)

Most common metabolic disease in children and adolescents

According to the Helmholtz Zentrum München, "Type 1 diabetes is the most common metabolic disease in childhood and adolescence." The cause is the destruction of the insulin-producing cells of the pancreas by the body's immune system. While in healthy people such excessive immune responses are suppressed by regulatory T cells (Tregs), this protection does not apply to type 1 diabetics. The result is the development of autoimmune disease.

Protective mechanism does not work in type 1 diabetes

Why the protection of Tregs in Type 1 diabetes does not work, the research team led by Drs. Carolin Daniel, group leader at the Institute for Diabetes Research (IDF) of the Helmholtz Zentrum München and a researcher at the German Center for Diabetes Research (DZD), in his latest study. According to Dr. Daniel was able to explain to scientists "a mechanism that causes less Tregs to be produced at an early stage of type 1 diabetes", so that "the immune system can become more uncontrolled."

Two molecules are crucial

According to the researchers, two molecules play a crucial role in the low Tregs production: the molecules miRNA181a and NFAT5. MiRNA181a induces activation of the transcription factor NFAT5 in the early stage of type 1 diabetes, which in turn leads to inhibition of Tregs and increased immune activation, explains Dr. med. Daniel. Further studies have shown that disruption of the miRNA181a / NFAT5 axis results in significantly less activation of the immune system and increased Treg formation. This was achieved both by the pharmacological inhibition of miRNA181a and NFAT5.

Suppression of the immune reaction possible

The director of the IDF, Prof. Dr. med. Anette-Gabriele Ziegler, emphasizes that the targeted inhibition of miRNA181a or NFAT5 could open new avenues "for reducing the activity of the immune system against its own islet cells." In addition, the combination with other immunomodulatory approaches forms a prospective intervention attempt in perspective. The present findings will now be further investigated in preclinical tests, with humanized models to check "whether the combination of insulin vaccine and inhibition of the miRNA181a / NFAT5 axis makes the immune system more tolerant of insulin-producing cells", explain the scientists.

New approaches to therapy

Type 1 diabetes is so far incurable and those affected must life-long their blood sugar by means of medication regulate, which sometimes leads to difficulties in compliance with blood glucose levels. Derailment of blood sugar levels can in turn cause significant health problems. For years, physicians have been looking for ways to stop the autoimmune disease or the destruction of insulin-producing cells of the pancreas early. Blocking the two discovered molecules could open up completely new options in the future. (Fp)