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Diabetes type 1 treatment hope for gene variant

Wednesday May 26th 2021

Scientists working on immunotherapy for type 1 diabetes have found a promising approach for newly diagnosed patients with certain gene types.

Professor Johnny Ludvigsson at Linkoping University in Sweden, and his team, tested the effects of injecting a protein called GAD into patients' lymph nodes. They hoped that this protein, together with vitamin D tablets, could help preserve insulin production.

They recruited 109 patients aged between 12 and 24 years, who had been diagnosed in the previous six months. Participants received either three intralymphatic injections of GAD, one month apart, plus vitamin D tablets, or placebo.

This showed that patients with the specific gene variation HLA DR3-DQ2 had significantly improved insulin production after treatment, but those with other genes did not.

Findings appeared in Diabetes Care recently. The authors write: "Intralymphatic administration of GAD-alum is a simple, well-tolerated treatment that together with vitamin D supplementation seems to preserve C-peptide in patients with recent-onset type 1 diabetes carrying HLA DR3-DQ2.

"This constitutes a disease-modifying treatment for type 1 diabetes with a precision medicine approach."

They explain that this approach alters the immune defence by inserting a protein that the cells of the immune system react to - a form of vaccination. GAD is known to cause the immune system to produce antibodies in type 1 diabetes patients. The aim is to make the immune system more tolerant against the body's own GAD and stop attacking the insulin-producing cells.

Professor Ludvigsson says: "People with diabetes who can produce a certain amount of insulin naturally do not develop low blood sugar levels, hypoglycaemia, so easily. They also have a lower risk of developing the life-threatening condition ketoacidosis, which can arise when the insulin level is low."

Ludvigsson, J. et al. Intralymphatic glutamic acid decarboxylase with Vitamin D supplementation in recent onset Type 1 diabetes: a double-blind randomized placebo-controlled Phase IIb trial. Diabetes Care 21 May 2021; doi: 10.2337/dc21-0318

[abstract]

Tags: Diabetes | Europe | Genetics | Pharmaceuticals

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