Preventing the Onset of Type 1 Diabetes

Diabetes researchers at Saint Louis University have discovered a way to prevent the onset of Type I diabetes mellitus in diabetic mice. This strategy involves inhibiting the autoimmune processes that result in the destruction of the insulin-secreting pancreatic beta cells.

Type I diabetes is a life-long disease that results from insufficient production of the vital anabolic hormone insulin. In most cases of Type I diabetes mellitus, the body’s immune system destroys insulin-producing beta cells, and this insulin deficiency causes high blood sugar levels, also known as hyperglycemia. Treatments for the disease require daily injections of insulin.

Dr. Thomas Burris, chair of the university’s pharmacological and physiological science department, and his colleagues, have published their results in the journal Endocrinology. IN this paper, they report a procedure that could potentially prevent the onset of the disease rather than just treating the symptoms

“None of the animals on the treatment developed diabetes even when we started treatment after significant beta cell damage had already occurred,” Burris explained in a prepared statement. “We believe this type of treatment would slow the progression of type I diabetes in people or potentially even eliminate the need for insulin therapy.”

A group of immune cells known as lymphocytes come in two main forms: B lymphocytes, which secrete the antibodies that bind to foreign cells and neutralize them, and T cells, which recognize foreign substances and regulate the immune response. There are several different types of T lymphocytes, but for the purposes of this discussion, two specific subtypes of T lymphocytes seem to be responsible for the onset of Type I diabetes. T “helper cells” that have the CD4 protein on their surfaces, and T “cytotoxic “ cells have the CD8 protein on their cell surfaces seem to play a role in the onset of Type I diabetes, but a third subtype of T lymphocyte has remained a bit of an enigma for some time. This subtype of T lymphocytes is a subcategory of CD4 T cells and secretes a protein called “interleukin 17,” and is, therefore, known as TH17.

Dr. Burris and his collaborators from the Department of Molecular Therapeutics at the Scripps Research Institute have been examining TH17 cells for some time and they came upon a pair of nuclear receptors that play a crucial role in the development of TH17 cells. Could hamstringing the maturation of TH17 cells delay the onset of Type 1 diabetes mellitus?

Burris and others targeted these receptors by using drugs that bound to them and prevented them from working. This prevented the maturation of the TH17 T lymphocytes. When two nuclear receptors, Retinoid-related orphan receptors alpha (ROR-alpha) and Gamma-t (ROR-gamma-t) were inhibited, they prevented the autoimmune response that destroyed the beta cells.

To block these ROR alpha and gamma t receptors, Burris and others used a selective ROR alpha inhibitor and a gamma t inverse agonist called SR1001 that was developed by Dr. Burris. These drugs significantly reduced diabetes in the mice that were treated with it.

These findings show that TH17 cells play a significant role in the onset of Type I diabetes, and suggest that the use of drugs like these that target this cell type may offer a new treatment for the illness.

According to the American Diabetes Association, only 5% of people with diabetes have the Type I form of the disease, which was previously known as juvenile diabetes because it is usually diagnosed in children and young adults. The organization said that over one-third of all research they conduct is dedicated to projects relevant to type 1 diabetes.

Rare Stem Cell Heals Damaged Lungs; Notch Signaling May Hold the Key to Lung Fibrosis

Patients who survive an acute lung injury are able to recover their lung function, which suggests that adult lungs regenerate to a certain extent. Depending on the cause and severity of the injury, multiple progenitor cells, including alveolar type II cells and distal airway stem cells, have been shown to drive lung tissue regeneration in mice. Now, Andrew Vaughan and others have described another cell type in the lungs involved in the repair process in mice when mouse lungs are damaged from influenza virus infection or inhalation of the anticancer drug bleomycin.  This cell type is called the rare lineage-negative epithelial progenitor (LNEP).

LNEP cells are quiescently present within normal distal mouse lung and do not express mature lineage markers (for example, a protein called club cell 10 or CC10 or surfactant protein C, otherwise known as SPC).  However, Vaughan and others demonstrate that LNEPs are activated to proliferate and migrate to damaged sites and mediate lung remodeling following major injury.

Vaughan and others used lineage tracing approaches and cell transplantation strategies and showed that LNEP cells, but not mature epithelial lineage cells, are multipotent in their ability to give rise to both club cells and alveolar cells.  Interestingly, activation of the Notch signaling pathway in LNEP cells initially activated them, but persistent Notch activation inhibited subsequent alveolar differentiation, resulting in failed tissue regeneration (characterized by the formation of abnormal honeycomb cysts in the mouse lung).  Thus Notch signaling is only required at the beginning of their activation, and then must be down-regulated if the LNEP cells are to reconstruct normal lung tissue.  Interestingly, scarred over or fibrotic lungs from patients with idiopathic pulmonary fibrosis or a disease called scleroderma show evidence of hyperactive Notch signaling and their lungs also contain very similar-looking honeycomb cysts.  This strongly suggests that dynamic Notch signaling also regulates the function and differentiation of LNEP-analogous human lung progenitor cells.  Thus designing treatments that properly regulate Notch signaling and, consequently, LNEP activity may potentially halt the development of lung fibrosis in humans.