A solid step toward vaccinating against type 1 diabetes

Scientists at Stanford are working on a vaccine to stop a type 1 diabetic's immune system from attacking the cells that make insulin.

Lawrence Steinman is a professor of neurology and neurological sciences, pediatrics, and genetics. Stanford University

Most vaccines work by giving the immune system a crash course in how to attack bacteria or viruses. The goal is to protect against diseases -- think influenza, polio, and smallpox, which have collectively killed tens of millions of people in recent history.

Now an experimental vaccine being developed at Stanford University uses an entirely different approach to get at the same end goal -- protecting against type 1 diabetes by instructing a diabetic's immune system to stop attacking its own body.

Unlike type 2 diabetes, which typically occurs when the body becomes resistant to the effects of insulin, type 1 diabetes is a predominantly genetic disorder that leads to the immune system attacking insulin-producing cells in the pancreas. This leads to insufficient production of insulin and requires regular injections of it throughout one's life.

The World Health Organization estimates that roughly 1 in 10 of the 347 million people in the world with diabetes have type 1.

If the new vaccine works, those 35 million or so with type 1 diabetes may be able to replace their daily insulin injections with a bimonthly vaccination instead.

For four decades researchers have tried to get the immune system to stop attacking those insulin-producing cells. The use of a vaccine to reverse the process, however, is novel.

"This vaccine is a new concept," Lawrence Steinman, senior author of the study and co-founder of Tolerion, the new company that plans to commercialize the vaccine, told the BBC. "It's shutting off a specific immune response."

The vaccine, called TOL-3021, is currently being studied on 80 type 1 diabetics receiving insulin injections. It employs a plasmid -- a small round piece of DNA -- that is genetically engineered to soften the immune response to insulin and ultimately keep in tact those insulin-producing beta cells. "It's a complicated series of snips and cuts in the DNA that take away the capability to stimulate the immune system," Steinman told Reuters.

Blood tests showed that the level of white blood cells that attack beta cells dropped after patients were given weekly shots for three months, and that their beta cell function improved beyond that found in patients who were treated with only insulin. Meanwhile, other parts of the immune system seemed unaffected.

The research is still at an early stage; this small study was to investigate safety and dosage. Larger trials involving more people over extended periods of time will be required to determine both safety and efficacy. But these initial findings suggest that the protective effect of the vaccine lasts for up to two months -- far longer than the effect of an insulin shot.

 

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