Type 1 research

[Guest guest]

Alberta seems to be in the forefront of diabetes research recently. The

following article was published by Toronto Star today.

http://www.thestar.com/thestar/editorial/health/20000817NEW02b_CI-DIAB.html

Calgary researchers find secret of diabetes

Discovery of new step in disease's growth fuels hope of vaccine

August 17, 2000

By Talaga

Toronto Star Medical Reporter

Calgary researchers have discovered a key step in the development of Type 1

diabetes, a finding which could lead to a preventive drug or vaccine to stop

the onset of the disease.

Almost 225,000 Canadians have Type 1, or juvenile, diabetes - the more

severe variety that forces them to rely on insulin injections to survive.

And the research could also mean breakthroughs in preventing other

immune-system disorders such as lupus, multiple sclerosis, rheumatoid

arthritis and inflammatory bowel disease.

Speaking for colleagues from Alberta, the U.K., and the B.C. Children's

Hospital, Dr. Pere Santamaria of the University of Calgary said the

important discovery is how the disease slowly develops over time.

The team has pinpointed how a diabetic's immune system becomes focused on

destroying islet cells, tiny cells that are scattered like grains of sand

throughout the pancreas. Islet cells produce insulin, a hormone needed to

break down carbohydrates in order to feed the vital organs. As a result,

diabetes slowly damages those organs, leaving the diabetic at higher risk of

losing a limb, developing heart disease, blindness and kidney failure.

It's hoped that one day, this research could help scientists develop a

vaccine to stop the immune system's destructive acts, said Ron Forbes,

president of the Juvenile Diabetes Foundation of Canada. ``We consider this

to be a very important step forward in the prevention of diabetes,'' said

Forbes, whose foundation helped fund Santamaria's work.

Recently, Alberta scientists have made great strides toward conquering

diabetes. In June, a team from the University of Alberta announced it had

found a way to transplant the islet cells of dead donors into the livers of

Type 1 diabetics. Eleven diabetics have undergone the so-called Edmonton

Protocol and all continue to live diabetes-free.

The Calgary study focuses on the behaviour of white blood cells - soldiers

dispatched by the body's immune system when it detects a foreign invader or

injury.

``In some diseases, the immune system turns against you and actually causes

the disease. Diabetes is one of those diseases,'' Santamaria said from his

Calgary office.

Since Frederick Banting and Best discovered insulin in 1922,

Canadian researchers have led the world in diabetes research, said Alan

Bernstein, president of the Canadian Institutes of Health Research.

``This research suggests ways to prevent, reduce or eliminate risk or the

severity of diabetes, and it has profound implications for individuals and

their families,'' Bernstein says.

All white blood cells have receptors, or eyes, on their surfaces, said

Santamaria. These eyes cause them to detect and be attracted to certain

things - for example, some can see parts of the influenza virus. The immune

cells find them, attach themselves, start to multiply and fight the

infection.

But in the case of Type 1 diabetes, they are attracted to protein markers on

the islet cells. Not all white blood cells can pass through the pancreatic

tissue, but ``the eyes lead them there. Then they sit, and accumulate,'' he

said. ``But what we discovered is that there is competition inside.''

Among the white cells inside the pancreas, it was discovered, there are two

varieties: weak and strong. Those causing the most damage are the more

powerful cells, which fight the weak ones for supremacy.

This can take months or years, Santamaria said, before the strong cells can

crowd out the weak and completely destroy the islet cells, causing

insulin-dependent diabetes.

``We akin this to the survival of the fittest,'' Santamaria added.

Knowing that these strong white cells do the most damage, but are often

delayed by their struggles with the weak cells, is expected to greatly aid

efforts to find a treatment to shut down their attacks on islets.

Researchers found that if they treat mice predisposed to diabetes with a

protein, they can stop the destruction of the islets. But Santamaria said

it's important to be cautious, as the research is still in mice and further

study is still needed.

Santamaria's work gives scientists a glimpse into how other auto-immune

disorders such as lupus, Crohn's disease, rheumatoid arthritis and multiple

sclerosis evolve, said Dr. Elliott, an immunologist with the University

of Alberta and a member of the Edmonton Protocol team.

``This paper gives us other insights,'' Elliott said. ``But it is important

to remember these are mice, and not humans.''

The Calgary research is published today in the journal Nature.