Type-1 diabetes is an autoimmune disease, chronic and incurable. More than 9.5 million people worldwide are affected. For a long time there was only one therapy: injecting insulin. Thanks to increasingly better technologies, insulin delivery can be adjusted more precisely and thereby keep the disease well in check for most people. But there is no cure yet.
Approaches to replace beta cells in the pancreas, which are destroyed by the body’s own immune system, are complicated. In severe cases, the organ or the insulin cell complexes, the so-called islets, can be transplanted. But in order to prevent rejection or renewed destruction by the self-destructive immune system, patients must take lifelong immunosuppressants. These medications suppress parts of the immune system and thereby increase the risk of cancer and infections.
The Study
Here a new study in the journal Journal of Clinical Investigation builds on this. Researchers at Stanford University were able to cure mice with Type-1 diabetes. With the aim of restoring the body’s ability to produce insulin on its own, they realigned the misdirected immune system and replaced the destroyed cells. For the first goal, the immune system of a diabetes-prone mouse was complemented with that of a healthy mouse. The researchers transplanted the blood stem cells from a donor mouse into the bone marrow of the sick one. From the stem cells, blood and immune cells develop.
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To put such stem cells into the bone marrow, the body would normally have to be subjected to harsh irradiation to completely remove the old immune system. The old and new immune cells would otherwise destroy each other. But the researchers found a solution: With mild irradiation they created a niche in the bone marrow and, using antibodies, downregulated the immune response to the new cells.
The new immune system regards both sets of cells—the donor’s and the recipient’s—as belonging to the same individual. Consequently, the pancreas from the donor mouse was transplanted into the sick mice, and insulin production was restored – without an autoimmune reaction.
What does it bring?
The mixed immune system is a new method in the fight against autoimmune diseases. The study authors hope the method could also help, for example, with rheumatoid arthritis. So far, the results exist only in animal models. To what extent the approach can be translated to humans remains unclear.
Moreover, the method apparently only worked in female mice, says Baptist Gallwitz, spokesperson for the German Diabetes Association. For the long road to clinical studies in humans, many steps are still needed. But Gallwitz adds: “It is a beacon of hope at the end of a long tunnel toward a cure.”
