Scientists create vaccines for type 1 diabetes

According to Centers for Disaster Control and Prevention, about 1.6 million Americans have type 1 diabetes. Every year, those numbers get worse. Globally, the number of people living with type 1 diabetes appears to be increasing by about 3-4% annually.

As it is mainly seen in children, adolescents and young adults, the disease was previously known as juvenile diabetes. However, middle-aged adults and the elderly can also be diagnosed with it.

Unfortunately, there is no cure. The main treatment options include a diet low in carbohydrates and sugar with daily insulin injections. Although insulin pumps have started to replace insulin injections, many diabetic patients do not have access to this more advanced medical technology and must receive insulin injections every day for the rest of their lives. There are of course other options, but they come with serious risks and lifelong consequences. Pancreas transplants, for example, are limited to the most unmanageable cases due to the health risks, and patients who benefit from them are usually required to take anti-rejection drugs for the rest of their lives.

Although type 2 diabetes can be prevented by maintaining a healthy lifestyle and a healthy weight, there is nothing you can do to prevent type 1 diabetes. This is why scientists around the world are working on different types of vaccines. , which could reverse the disease and finally offer a viable cure.

What is diabetes ?

Diabetes is a metabolic disorder that causes high blood sugar because the body develops resistance to insulin (a condition in which cells do not respond to insulin) or because the pancreas does not make enough insulin to absorb glucose. Type 1 diabetes, however, is an autoimmune disease in which the immune system attacks and destroys insulin-producing cells in the pancreas, causing sugar to build up in the bloodstream.

In patients diagnosed with this disease, cells that synthesize insulin in the pancreas are attacked by cells of the immune system. This results in poor insulin secretion and results in an inability to process glucose, which then builds up in the bloodstream. It is not known what triggers the autoimmune response in the first place, but it may involve genetic factors or exposure to viruses and other environmental conditions.

This eventually gives way to a wide range of short and long term complications, many of which are life threatening. These include blindness, cardiovascular problems, nerve damage leading to amputation, kidney failure and inevitably death. In fact, type 1 and type 2 diabetes are actually some of the leading causes of lower limb amputation and blindness in adults.

Vaccination strategies for type 1 diabetes

• Antigen-specific vaccines

As mentioned, type 1 diabetes occurs when certain white blood cells fail to recognize insulin-producing beta cells as a normal part of the pancreas.

These white blood cells, called T cells, mistake the cells for intruders that invade and attack the pancreas, causing insulin production to drop.

Conventional vaccines enhance immune responses against foreign antigens by exposing the immune system to them in a controlled manner. On the contrary, in vaccination against type 1 diabetes, the goal is to inhibit the incorrect immune response against beta cells. This is called reverse vaccination.

Because the reduction in the number or function of T cells would affect the entire immune system, scientists have studied antigen-specific vaccines. These would work alone on diabetes autoantigens to boost immune tolerance.

These vaccines are based on specific pancreatic substances. Insulin-based vaccines have failed in humans, but scientists have found that certain compounds, called peptides, which help the body fight bacteria and promote wound healing, can induce anti-inflammatory responses. This is important because type 1 diabetes begins with insulitis, an inflammation of the pancreatic islets of Langerhans caused by white blood cells attacking the insulin-producing beta cells of the islets.

TThe most promising peptide is DiaPep277, a stable 24 amino acid peptide that activates anti-inflammatory and regulatory white blood cells. This peptide can decrease the immune response which leads to the destruction of beta cells and regulate this immune response to preserve beta cells. This vaccine is in a phase III trial.

• Peptide vaccines and modified ligands

APL vaccines are based on peptide fragments modified with amino acid substitutions that bind to MHC molecules.

MHC is the abbreviation for Major Histocompatibility Complex. It is a group of genes that triggers the detection of pathogens and the immune system’s response against them. APL vaccines manipulate this process to induce specific responses of white blood cells to prevent them from attacking beta cells in the pancreas.

Insulin-based peptides are candidates to act as modified peptide ligands in this type of vaccine because they can delay type 1 diabetes, research shows.

• Adjuvant-stimulated diabetes vaccines

To overcome the limitations of single peptide vaccines, scientists decided to add ingredients to make them stronger.

This is the case with specific immunotherapy for Dyamid antigen, created by Swedish biotechnology company Diamyd Medical. It is based on the GAD65 protein, an endogenous antigen involved in the pathology of autoimmune diabetes.

In clinical trials, this treatment has shown an improved and more selective immune response that has helped protect beta cells and insulin production.

Dyamid is currently in large-scale Phase III clinical trials.

Researchers at Massachusetts General Hospital have found that the Bacillus Calmette-Guérin (BCG) vaccine, created in 1921 to prevent tuberculosis, is also able to normalize blood sugar levels thanks to the Foxp3 T-cell regulatory gene, which is typically altered in diabetes. type 1.

By restoring normal gene expression in key immune cells, the vaccine can reduce beta cell destruction and even increase blood sugar consumption to achieve more balanced glucose levels.

Currently, Massachusetts General Hospital wants to start a pediatric trial but is awaiting FDA approval.

As you can see, there are several options at different stages of development that can end up being effective treatments for type 1 diabetes. We will have to wait and see if they will prevent the disease or even cure it. . Either way, this is great news for people with type 1 diabetes or those at risk for the disease.