Thursday, February 9, 2017
Back in October 2016 was the European Association to Study Diabetes (EASD) conference, which is the largest scientific meeting on diabetes in Europe. Much like ADA, it covers both type-1 and type-2 diabetes. The Europeans are way ahead of the American in terms of on-line access. The EASD 2016 web site has recordings of many of the talks, and much more content than the ADA web site. You can see it here:
Clinical Trials Aimed at Curing Type-1 Diabetes
The only research which I saw which was directly aimed at curing type-1 diabetes was a talk and a poster given by Dr. Ali from the Cardiff Diabetes Vaccine Development Center (which is part of Cardiff University, Wales, UK). This is part of the ongoing work by Dr. Peakman and others.
Results of the Monopept1de Phase-I Trial of An Insulin Peptide
This research has been on-going for at least 10 years. Here is my previous blogging:
The basic idea is to give people with type-1 diabetes an injection containing part of the insulin molecule, which will teach the body's immune system not to attack itself. The idea is vaguely similar to giving people tiny amounts of peanut protein to desensitize them from peanut allergies. It is important to remember that type-1 diabetes is NOT a classic allergy. The analogy is not perfect, but that's the general idea.
The study showed that the treatment was safe and did not trigger any serious adverse effects, or unexpected adverse effects of any kind. The success/outcome data was weaker. C-peptide production did NOT increase, but insulin usage went down, and H1c numbers showed a downward trend in treated people. None of this is strong data for effectiveness, but this trial was aimed at gathering safety data. The researchers think the safety data is plenty strong enough to support a phase-II study.
11 Minute Talk: http://www.easdvirtualmeeting.org/resources/proinsulin-peptide-immunotherapy-in-new-onset-type-1-diabetes-is-well-tolerated-and-associated-with-reduced-daily-insulin-usage-203021b2-7c50-4239-81b8-84fe0d8a0291
Older Poster On The Same Research: http://www.easdvirtualmeeting.org/resources/proinsulin-peptide-immunotherapy-in-type-1-diabetes-safety-data-of-a-first-in-new-onset-type-1-diabetes-phase-1b-trial--2
This same research group is working on another clinical trial called "MultiPepT1De", which is testing using several different proteins at once. The trial reported on here only used one. The MultiPepT1De trial was scheduled to finish in Feb-2017, but is running late:
Other Interesting Talks
This was a 15 minute talk by Dr. Denise Faustman, where she discusses a particular chemical pathway (TNFR2):
Viral Infections as Triggers
The talk in the next link discussed looking for viruses in the pancreases of 6 newly diagnosed adults. It is 30 minutes long and has 114 slides:
These researchers are trying to answer the question "does a viral infection trigger type-1 diabetes", by looking at pancreases close to the time of diagnosis. They did find more viruses in people with type-1 diabetes, but it was low grade persistent infection, not an acute infection. They were all enteroviruses, no two of the same strain, and the exact virus could not be identified (due to low levels).
Also, they found that 36% of the islets were still producing insulin approximately 5 weeks after diagnosis, which is higher than previous estimates that I'm familiar with. This definitely comes down on the "viruses are involved in triggering type-1", but the study was a small pilot study, in need of follow up.
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All the views expressed here are those of Joshua Levy, and nothing here is official JDRF or JDCA news, views, policies or opinions. My daughter has type-1 diabetes and participates in clinical trials, which might be discussed here. My blog contains a more complete non-conflict of interest statement. Thanks to everyone who helps with the blog.