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Immune toleration to prevent diabetes

Drug Discovery - Scientists believe they have found a preventative therapy for Type 1 diabetes, by making the body's killer immune cells tolerate the insulin-producing cells they would normally attack and destroy.

Type 1 diabetes is an autoimmune condition, where the body attacks its own insulin producing cells. It is very serious, with a sudden and dramatic onset, usually in youth. People with Type 1 diabetes must maintain an insulin-monitoring and insulin-injecting regimen for the rest of their lives.

Eliana Marino and Dr Shane Grey, from the Garvan Institute of Medical Research in Sydney, have demonstrated how a particular molecule may be used in future as a preventative therapy. Working with mice that spontaneously develop Type 1 diabetes, Eliana Marino found that if she blocked BAFF (a hormone that controls survival of B cells) prior to onset, none of the mice developed diabetes.

"This is a remarkable finding, as other B cell depletion methods tested elsewhere have just delayed or reduced disease incidence," said Eliana.

When B cells were depleted, the regulators of the immune system (a subclass of T cells known as T regulatory cells) rose in numbers. By removing B cells from the picture for a while, it appears you allow T regulatory cells to function as they should, subduing killer T cells and somehow making them tolerant of the insulin producing cells.

BCMA - the molecule used by Grey and colleagues to inhibit BAFF - is already being used in clinical trials for other autoimmune diseases, such as Sjogren's Syndrome and Lupus.

Their findings are published online in the international journal Diabetes.

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