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DIABE T E S


Breakthroughs in diabetes research


This year, the 80th American Diabetes Association Scientific Sessions took place online, with 12,500 attendees coming together virtually to share the latest on treatments, advances and support for people living with diabetes. The Charity, Diabetes UK, recently shared some of the key findings from the event.


In 2019, approximately 463 million adults (20-79 years) were living with diabetes; by 2045 this will rise to 700 million (figures cited by the International Diabetes Federation). With diabetes causing 4.2 million deaths and costing at least USD 760 billion dollars in health expenditure in 2019 (10% of total spending on adults), finding new therapies to prevent and treat the condition is a high priority. The 80th American Diabetes Association Scientific Sessions highlighted some of the most promising new treatments on the horizon for diabetes – including beta cell replacement.


Type 1 diabetes: promising research Around 10% of all people with diabetes have type 1 diabetes, which is caused by an autoimmune reaction where the body’s defence system attacks the cells that produce insulin. As a result, the body produces very little or no insulin. The exact causes of this are not yet known but are linked to a combination of genetic and environmental conditions. Potentially, if the beta cells destroyed in type 1 diabetes could be replaced, it would be possible to help people make their own insulin and take a significant step towards a cure. However, Diabetes UK explains that there are two significant challenges: although transplants from donors already exist, there are not enough donor cells to help everyone who could benefit. Secondly, the immune system in people with type 1 diabetes is primed to attack new beta cells.


Scientists are making progress in solving the supply problem, finding ways to grow a potentially unlimited supply of beta cells in the lab, using stem cells. If these newly created beta cells are to be of use, they need to be protected from the immune system, however. Speaking at the online event, Dr. Audrey


Parent, from the University of California, presented her work, which aims to solve this issue.


A group of genes, called HLAs, are responsible for speaking to our immune system. Dr. Parent is hoping to silence beta


One protein, BAH2, could restore beta cells back to their fully mature, insulin-producing state. Another, called AFF3, helped convert alpha-like cells back to beta cells.


66 l WWW.CLINICALSERVICESJOURNAL.COM


cells by genetically modifying them so that they are missing most of their HLAs. This could allow them to ‘fly under the immune system’s radar’. Dr. Parent and her team tested to see if the genetically modified beta cells fare better than cells that haven’t had their HLAs deleted. They transplanted the different types of beta cells into mice. After 14 days, in mice that received non-modified cells the researchers started to see a decline in the quantity of cells. This became more pronounced by 28 days. However, cells with deleted HLAs did not show the same decline – more of them survived suggesting they are protected against the immune response. Although this is very early stage research, the approach looks promising. Last year, TrialNet researchers announced the results of their breakthrough type 1 prevention trial, which showed that an immunotherapy drug, called teplizumaub,


SEPTEMBER 2020


©Sherry Yates


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