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Possible Cures for Type-1 in the News (January)

Discussion in 'Research' started by joshualevy, Jan 9, 2021.

  1. joshualevy

    joshualevy Approved members

    Dec 30, 2008
    Beta Cells Which Hide From The Immune System

    This has not progressed to clinical trials, but it is a new approach. There is a lot of ongoing research into creating beta cells which will generate insulin in response to blood glucose, and many people talk about these as though they were a cure. But they aren't, at least not by themselves, and for two reasons. First, as a foreign cell they are properly attacked by the immune system. Second, type-1 diabetes is caused by the immune system improperly attacking beta cells. So there are two reasons why the T1D immune system is going to attack and destroy these cells.

    However, the Salk Institute has found a recipe which takes stem cells and creates functional beta cells which are invisible to the immune system. They call them "Immune-evasive". In theory, this could protect the cells from both kinds of immune system attack, and these cells could, by themselves, cure type-1 diabetes.

    Obviously, I'm going to be very interested in the research when/if it moves to human trials. The press release from Salk makes it clear that these cells are not even ready for human trials, yet. They need to undergo another round of animal testing, and then they can start the 10-15 years of human trials required for approval.

    This is exactly the kind of research where human trials are important. They are trying to create human cells which are hidden from the human immune system, but they must work in mice to start with. So they are working with a specific kind of mouse called a NOD/SCID mouse. The NOD refers to mice which have autoimmune diabetes. NOD mice are the standard mice used to research cures to T1D. The additional "SCID" refers to mice in which it is possible to experiment with human cells, because their immune systems have been modified to allow it. So NOD/SCID mice are quite different than NOD mice. That is a two edged sword. The researchers must do it, because they can't start out experimenting on people, and yet they need to create human cells. But SCID is a big change to the mouse immune system, changing three basic types of immune cells. So this research is not going from mice to humans, it is going from highly modified mice to humans. For me, this is an even larger jump, so the first human results are even more important.

    News Articles: https://www.sciencedaily.com/releases/2020/08/200819110923.htm
    Press Release: https://www.salk.edu/news-release/first-immune-evading-cells-created-to-treat-type-1-diabetes/
    Scientific Article: https://www.nature.com/articles/s41586-020-2631-z

    No Results from A Phase-I Trial of Ustekinumab

    In 2014 a Phase-I clinical trial started to test Ustekinumab on people with honeymoon type-1 diabetes. They completed enrollment on May 24, 2016, which means they should have finished gathering data by May 24, 2017 and published results by May 2018. Successful results are usually published in less than a year after completion. But now it is well past May 2020, and I can not find any results from the study.

    From my point of view, this means the study was unsuccessful.

    You can read my previous blogging on this treatment here:
    I think there have been a total of three studies done on Ustekinumab, but only one is still active. That one is in the UK and expected to finish in Oct-2022. You can read more about it here:

    Clinical Trial Registry: https://clinicaltrials.gov/ct2/show/NCT02117765

    Reminder: Once Weekly Basal Insulin Under Development

    This is not a cure, but I'm sure some people will find it interesting. Novo Nordisk has finished phase-II trials on an insulin that you use once a week to cover your basal needs. You still need to take insulin for meals, but it replaces daily (or twice a day) basal insulin injections with just one injection a week. It is called Insulin Icodec, and still needs to go through phase-III clinical trials before it is approved for use.

    Fun Web Article on the History of Clinical Trials


    publicjoshualevy at gmail dot com
    All the views expressed here are those of Joshua Levy, and nothing here is official JDRF or JDCA news, views, policies or opinions. My daughter has type-1 diabetes and participates in clinical trials, which might be discussed here. My blog contains a more complete non-conflict of interest statement. Thanks to everyone who helps with the blog.

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