Type 1 Diabetes: Steps Toward A Cure
By: Adrian Martinez
Type 1 diabetes is characterized by the body’s inability to produce insulin. This can occur through the body’s own immune system attacking and destroying cells, beta cells, in the pancreas that produce insulin. It can also occur due to injury to or disease of the pancreas, this is commonly known as secondary diabetes and has similar results as type 1. The production of insulin is important because of its role in moving glucose into body tissue and, in turn, allowing the tissue to utilize the glucose as fuel. Thus, no insulin production leads to no glucose entering tissue, this leads to high blood sugar, and ultimately cell damage through starvation. If left untreated life-threatening problems could occur such as kidney damage, poor circulation, nerve damage, or death.
People afflicted with the disease must routinely monitor their blood glucose levels and administer the correct amount of insulin based on their levels, food intake, and activity state. The administering of insulin is commonly done through injection or insulin pump. People who always monitor their glucose levels and administer insulin accordingly are able to live a healthy long lives. However, the key thing to realize is that this is a lifelong process that must be repeated daily and may become burdensome. What if there were a solution or cure that resolved all of this? Well recent research published in the journal Nature may get us a step closer to doing exactly that.
First off let us revisit the pancreas. As stated before, the pancreas contains beta cells that produce insulin, but it also contains cells, called alpha cells. These alpha cells produce a hormone called glucagon which can be thought of the opposite of insulin in that instead of decreasing concentrations of glucose in blood it raise these concentrations. Unlike the beta cells, alpha cells are not affected by the destructive autoimmune response seen in type 1 diabetes. In stating this, we have the basics to understand the general idea and importance of the research.
The researchers examine whether alpha cells are able to be manipulated in such a way that instead of producing glucagon they produce insulin. This is done by exposing alpha cells with a virus that causes the cells to express specific transcription factors (proteins that turn on or off certain genes) that are normally found in beta cells. These transcription factors are PDX1 and MAFA, and are required for beta cell maturation.
After exposure to the virus, alpha cells were seen to produce insulin. These reprogrammed cells were then implanted into diabetic mice. It was observed that these mice became normoglycemic. When these cells were removed hyperglycemia reappeared. This shows that the cells are responding to circulating glucose in the blood and releasing insulin in response, thus normalizing glucose levels. It is also observed that these cells are less prone to the devastating effects of the autoimmune response that causes the deletion of beta cells.
More research is needed to truly examine whether the new cells are capable of surviving long-term and continue to produce insulin in type 1 diabetic mice or even humans. This research, however, gets us closer to answering those questions and finding an effective treatment for type 1 diabetes.
References:
Furuyama, K., Chera, S., Gurp, L. V., Oropeza, D., Ghila, L., Damond, N., Herrera, P. L. (2019). Diabetes relief in mice by glucose-sensing insulin-secreting human α-cells. Nature, 567(7746), 43–48. doi:10.1038/s41586–019–0942–8
