Transcript
Narrator:
The Diabetes Research Institute presents a series of reports on the latest progress in cure-focused research – promising discoveries aimed at restoring natural insulin production in those living with diabetes.
Reporter:
Your immune system is supposed to attack foreign matter – like bacteria -- when it enters your body. That protects you from infections and viruses.
But sometimes, the immune system malfunctions … and attacks parts of your own body. That’s called autoimmune disease.
And that’s what happens with type 1 diabetes. The immune system destroys the cells in the pancreas which produce insulin.
At the Diabetes Research Institute, Dr. Alberto Pugliese and his research team are studying ways to prevent autoimmune attacks.
Pugliese:
“What we’re trying to do here is trying to stimulate regulation, trying to stimulate the immune system not to be autoreactive.”
Reporter:
His focus: a subset of cells which help regulate the immune system.
They’re called dendritic cells. They’re found in many places, including the thymus, spleen, and lymph nodes.
Their job: both to stimulate the immune response … and suppress it.
Pugliese:
“They actually express insulin themselves and the reason why they do that is, we believe, that they use that insulin to actually modulate the immune system, and in particular interact with the lymphocytes, or the immune cells that can attack insulin and actually regulate them. So we’re trying to study those cells and see whether we can use those to actually specifically down-regulate the immune responses that are associated with diabetes.”
Reporter:
The goal: to create what scientists call “self-tolerance.” That is, to re-educate the immune system, so it sees insulin as part of the “self” – and does not attack it.
If successful, this work could play a key role in reversing diabetes over the long term. Currently the DRI is pursuing several pathways to restore natural insulin production in patients with type 1 diabetes.
But, the concern is that even when insulin production is restored, there could be a recurrence of autoimmunity – and diabetes would return. In clinical trials, the DRI has transplanted insulin-producing islet cells into patients with type 1 diabetes. Scientists suspect that, over time, those cells are losing function at least in part because of the recurrence of autoimmunity.
Pugliese:
“The main problem with diabetes is the autoimmunity. If you were able to take care of that, anything else that you need to do to take care of the disease will follow. It will be easier to do. Like in transplantation, we have recurrence of autoimmunity. So it is an important obstacle and is probably is even underappreciated at the moment.”
Reporter:
Another focus of Pugliese and his team is “cell regeneration” – getting cells within the pancreas to “re-grow” and produce insulin. In some other parts of the body, regeneration occurs routinely. With the liver, for instance. If you cut off part of it, it will grow back.
But, with the pancreas it was thought regeneration was not possible. Pugliese says, that’s changing.
Pugliese:
“Under certain situations some regeneration is possible. This has been seen, mostly are obviously experimental models in rodents, but the principle is there.”
Reporter:
Pugliese and his team are studying pancreases that have been transplanted into patients with type 1 diabetes.
In some cases, autoimmunity recurred in these patients … destroying the insulin-producing cells in their newly acquired organs.
Pugliese biopsied these pancreases, and found that insulin was being produced by cells that normally do not make insulin – cells found in the pancreases’ ducts. He says these ductal cells might be trying to compensate for the loss of the cells that usually produce insulin.
Pugliese says these findings, along with other research, suggest that the pancreas may have the ability to remodel and generate new insulin-producing cells.
Pugliese:
“So what we believe what’s happening there is that ductal cells were actually transdifferentiating into an insulin producing cell. So this could be another mechanism by which the body has the ability to correct a deficiency, in this case a deficiency of insulin producing cells.”
Reporter:
What they’re studying now is what controls that process at the molecular level – so that, hopefully, one can reproduce it or induce it.
And, whether the pancreas could regenerate enough cells to effectively control blood sugar. Pugliese says he is able to pursue answers to these and other questions because of the DRI’s clear commitment to cure-focused research..
Pugliese:
“It is an institution that is very focused and dedicated to find a cure for type 1 diabetes. It is an institution that wants to cure diabetes as quickly as possible. And so it has traditionally invested a lot on research that is more likely to translate more quickly to something that will have a benefit for the patients.”
Reporter:
He says the Institute’s main funding source – the DRI Foundation – makes this possible.
Pugliese:
“With the Foundation, we have not slowed down. It gives you the freedom to explore new ideas. That’s a great freedom and that’s a great advantage for scientists and for the patients.”
Narrator:
This has been a production of the Diabetes Research Institute Foundation.
For more information, or to show your support for the Diabetes Research Institute, call 1-800-321-3437.
You also may donate online at diabetesresearch.org.