Researchers from King’s College London and Cardiff University have tested a new immunotherapy treatment. The trial, which was partly funded by JDRF, indicated that the treatment was safe and suggests that it could have potential to preserve beta cell function in people living with type 1 diabetes (T1D).
Why did they do this trial?
T1D develops because the immune system mistakenly attacks the insulin-producing beta cells of the pancreas. One way of protecting beta cells would be to re-train the immune system to prevent it from attacking them. Treatments that alter the behaviour of the immune system in this way are known as immunotherapy.
Professor Mark Peakman and his team worked to develop a protein-based immunotherapy treatment, named MonoPepT1De (proinsulin C19-A3) . The aim of this trial was primarily to assess the safety of the treatment in a small group of people living with type 1 diabetes. The researchers were also looking out for signs that the treatment was working the way they hoped.
What did they do?
The team recruited 27 adult volunteers who been diagnosed with T1D within 100 days of starting the trial, and that had a specific genetic risk profile for T1D. The participants were split into three groups: two groups were given the treatment injection either every two weeks, or every four weeks, while the final group were given a placebo. The trial lasted six months. The researchers checked whether the treatment was safe, and also measured the amount of insulin the participants’ beta cells were able to produce , every three months for a year.
What did they find?
MonoPepT1De was safe to use, and appeared to preserve beta cell function. Participants receiving the treatment every four weeks did not experience a notable decrease in insulin production over the year, and they did not need to increase their injected insulin use across the year.
The placebo group’s insulin production meanwhile decreased across the year, and they needed to inject 50% more insulin every day by the end of the year. This suggests that those not taking the treatment were losing beta cells at a faster rate than those receiving the treatment.
What’s the next step
These results indicate that this therapy is safe.
The next step will be to conduct further clinical trials with more participants to better establish how effective the treatment is in preserving beta cell function and insulin production in people living with T1D, and if the approach would be safe in children as well as adults. As this trial only included people with a particular genetic risk profile, another step would be to see if the treatment is successful in a broader range of people with T1D.
What does this mean?
In the longer-term, this potential treatment could mean that those with a very new diagnosis of type 1 diabetes could protect their remaining beta cells for longer and require less insulin over time. It is also a step along the path to a preventative treatment for T1D.
What’s happening in Australia?
JDRF is currently funding lab-based research into a different immunotherapy using nanoparticles, led by Professor Ranjeny Thomas at UQ Diamantina Institute. Her team hopes to complete this research in order to bring it into early clinical trials in the future. JDRF is supporting many other projects in Australia in the area of immune therapies, including the role of different proteins and immune cells. The aim of this research is to prevent or delay beta cell damage and onset of T1D.