Want a Cure? Join Team Biobank!

Join the T1D Exchange Biobank - Be a Part of the Team 

Everyone who lives with type 1 diabetes (and their brother) wants a cure. 

To become a reality cures will take more than wishing to becme a reality. They will take research. Research needs people with diabetes to participate and maybe give a little blood. (Yes cures - I want variety of them - y'a know 'cause YDMV)

Seriously a little blood to the right researchers can help, only how do we know who needs the bio sample?

Enter the T1D Exchange. 

They have been pilot testing a biobank. It connects researchers and bio samples. The Exchange says, "To date, through the generous efforts of those willing to participate in this research, there are over 1,600 people enrolled and more than 450 test kit collections have been completed."

Full disclosure, my family are part of that 1,600. Yay Team Biobank!

The Exchange is moving from pilot test to public enrollment. Yay Team Biobank! 

Who doesn't like being part of a great team? Ok so it is tough to be part of the Patriots ball deflation squad but anyone with T1D can join Team Biobank.

Learn more and get started on sign up here: T1DExchangeLivingBiobank.org

Yay Team Biobank!

...and about Fido.

I just wrote about mice and my pal Mike remedied me that there are stories about dogs and gene therapy in the news. 

So that it is a different model than than mice. 

I have joked that you can spit on a NOD mouse and cure it. Still I welcome studies in animals to help find cures. If / when science get there, there may well be a variety of things that are cure-like. I expect better treatments will come first but I digress.

So a quick read of reports on the dog study finds interesting things, promoting insulin production and insulin regulation. Both of which lost in T1D with distraction of beta cells. Both are way cool and I hope lead to more discoveries and progress.

I would caution, as the reports do, that there is the issues that the dogs don't have an autoimmune process attacking the beta cells. In this case the beta cells were killed chemically.  So it maybe the gene thing is part of the process. Stopping the auto immune process seems the big part too. 

It maybe that the ability to reproduce beta cells is there in full onset but the autoimmune process overwhelms it. Consider for example Joslin has 50 year T1D Medalists who still have some beta cell function. That sure suggests that beta cell can rejuvenate even in long term full onset T1D. (Looking for the citation and I think it was mentioned on 'Rents Blog Talk Radio with John Brooks III.)  So the a key then is also stopping the auto immune process that kills them. 

http://www.popsci.com/science/article/2013-02/gene-therapy-cures-diabetic-dogs

http://www.newscientist.com/article/dn23163-gene-therapy-cures-diabetic-dogs.html?cmpid=RSS|NSNS|2012-GLOBAL|online-news

Josh's "Possible Cures for Type-1 in the News (Early Feb)"

It is that time.

Time to recommend reading Josh Levy. Once again I find myself spellbound by his blog and cautiously optimistic. Optimistic not about any give treatment necessarily but about the level of research and diversity of approaches and that somewhere in all of it there may be better treatments, partial cures and maybe... cures.

This month Josh writes about Trial of Polyclonal Tregs. There are immune regulatory cells. The idea is they take these from a person, make a bunch more in the lab and put them back in hope of restoring increasing the regulatory balance and preserving beta cell function. 

Learning about that is cool enough but what sets Josh apart for me is the detail of his discussion. He considers what constitutes remission for researchers. It is not necessarily what we would thing as PWDs. For researchers is is using half the insulin than otherwise, not none. Also Josh has a discussion of the ethics of research and the participation of children in the studies. This matters if a study is looking at the early stages just after diagnosis as there are far fewer adults available with recently diagnosed T1D than kids. This is an important conversation and I am thrilled to see it brought up in thoughtful manner. 

There is also a conversation of clinical trials on the cocktail mix of Cyclosporine and Lansoprazole. One to stop the autoimmune attack and the other to improve beta cell production. 

Science matters, understanding it does too and I think Josh does a better job month in and month out at reporting on the science of cures than any other single source I know.  As is usually the case my summaries of his blog don't do it justice. The best way I can think to say thanks is to I highly recommend  clicking over and having a look for your self.

Oh and while you are there sign up for his email updates.

http://cureresearch4type1diabetes.blogspot.com/2013/02/possible-cures-for-type-1-in-news-early.html

Josh's January Update on T1D Cure Research

Regular YDMV readers know I am a big fan and cheerleader for Josh Levy's site http://cureresearch4type1diabetes.blogspot.com. I like that someone smarter than me reads all these studies and like even more the reviews and discussions.

His January 2013 update is here: http://cureresearch4type1diabetes.blogspot.com/2013/01/possible-cures-for-type-1-in-news.html

Topics covered in detail include:

Kamada Alpha-1 Antitrypsin (AAT). 

This study is important for a couple of reasons.  First, because of the number of AAT clinical trials. I know of a five AAT clinical trials aimed at type-1 diabetes going on now.  That's a lot; more than any other single drug.

LCT Updates  

LCT is developing an encapsulated pig beta cell cure for type-1 diabetes. The coating allows blood sugar in, and insulin out, but does not allow the body's immune system to attack the beta cells. It also allows nutrients in and waste products out. This allows the beta cells to naturally grow and to react to the body's sugar by generating insulin which goes into the body's blood system. 

Update from Scott King on Islet Sheet Project 

An Islet Sheet is a specific beta cell encapsulation technique, similar to what LCT is trying to do.  Because Islet Sheets have not yet started human trials, I don't follow this research very closely.  However, I know others are very interested in it, and Scott King posted an update on his blog, which you can read here:http://www.hanumanmedicalfoundation.org/blog/2012/11/26/signal-breakthrough-islet-sheets-thrive-in-pig/ 

Back online. Good bit by Josh Levy

I had (have) computer issues. The iMac was in the shop. It just got out and seems to have the same problems. yay. go team. Anyway for now I am back in the land of the computing.  Anyone who says you can replicate the computing experience of a computer with an iPad is smoking dope.

One of the first things I saw was this recycled piece form Josh Levy. He made out a case that refutes 'the generic drug will never be researched for a cure because there are no profits in it." argument we sometimes hear. Nice to hear a some logic.

http://cureresearch4type1diabetes.blogspot.com/2013/01/funding-existing-drugs.html

Joshua Levy on Faustman

Joshua Levy writes a blog called Current Research into a Cure of Type-1 Diabetes.

Josh is super smart and articulate. I find his reviews of research to be excellent. They are not light reading. He just published a piece on Dr. Faustman's  phase 1 trial. I strongly encourage those interested in possible cures to subscribe to Josh's RSS feed. Also those interested in this particular research should have a look. I have only started reading it, it looks like it will take me a few re-reads to fully digest his summary of her work.

In the mean time if you are interested in digging in yourself, here is the link:
http://cureresearch4type1diabetes.blogspot.com/2012/08/details-of-dr-faustmans-phase-i-results.html

Stem Cell Reports and Asking questions.

There are a number of headlines about stem cells as a cure for type 1 that have been written in the past few days. They are based on a study out of China the reports to have reeducated lymphocytes aka T cells. I read this article and am left with far more questions than I am comfortable with. Josh Levy has a sound write up, I recommend his write up. 

In part here why I have questions. In other news this week identified CD8 T cells as the source of the autoimmune response that causes type 1.1 There is a quote from ViaCyte on Diabetes Mine that spoke  to the difficulty of  getting stem cells to differentiate into beta cells.2 For that I presume that getting a stem cell to differentiate into any specific cell is an involved proposition. 

The lymphocytes reportedly reprogramed in the China study are already differentiated cells.  If the autoimmune process is stopped it is due to a modification or reeducation of these CD8 T cells. There are a myriad of CD8 cells and they are created in the lymph nodes to recognize specific antigens on the cells the are programmed to kill. 

Differentiated means a stem cell became a specific cell in the body. That is they started off as a stem cell and became a specific type of t cell. Very loosely hematopoietic stem cel in bone marrow become a common lymphoid projenitor that becomes a T cell.

This study suggests that exposure to stem cells changes the existing antigen receptors. If that is true then why don’t the stem cell that become to the lymphocytes in our bone marrow have the same effect? I also fail to see a mechanism to explain how this erase the memory of the adaptive immune system. Why is it the type 1 autoimmune T cells that are reeducated and not say the one that provide immunity to chickenpox.  

All that said I would love to see a cure. I get excited by headlines just like everyone else. I hope this is repeatable. I have come to be suspicious of reports of apparatus that seem to good to be true. 

I would hope that the news agencies that report this kind of study know enough to ask some basic questions. Among them should be how does it work, is it peer reviewed and has the study been repeated? 

1 La Jolla Institute researchers identify pivotal immune cell in Type 1 diabetes in humans, http://www.eurekalert.org/pub_releases/2012-01/ljif-lji011112.php

2 http://www.diabetesmine.com/2012/01/whats-up-with-diabetes-stem-cell-research-firm-viacyte.html

#TwoBits on Cure Research. One Guy: Joshua Levy

Here’s a quick #TwoBits* from around the DOC.

We of us living with T1D want a cure. A lot of us also want an easy way to keep track of progress towards cure. My Go To Guy is Joshua Levy. In late December he wrote two essays well worth reading for those looking for cures. 

http://cureresearch4type1diabetes.blogspot.com/2011/12/two-essays-on-progress.html

Of Mice and Men: Joshua also started a new blog. One dedicated to all the NOD Mice that get cured. The freaking mice get cured all the time and each time starts a cycle of a cure is coming headlines. It is nice then to have a resource that knows the difference between curing mice and people while still keeping an informed eye on what is going one with the rodents. 

http://t1dcuredinmice.blogspot.com

*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

@JDRF New Research #TwoBits

JDRF announced two research initiatives today. The first is a study of seeking to Reduce Cardiovascular Risk in Adults with Type 1 Diabetes. From the release:

New York, NY, December  13, 2011-JDRF-funded researchers have begun enrolling adult patients with type 1 diabetes (T1D) in the REMOVAL study, to test whether metformin-a drug commonly used to treat type 2 diabetes-could help prevent or reduce the risk of cardiovascular complications in people with T1D. 

The REMOVAL study (Reducing with MetfOrmin Vascular Adverse Lesions in T1D) is a multi-center, international trial that will study 500 patients with T1D aged 40 or older, a patient group known to be at higher risk for cardiovascular disease, one of the leading causes of death associated with diabetes. A study from the United Kingdom has shown that people with T1D aged over 40 are at much higher risk for cardiovascular disease, including heart attack and stroke.

The second is in conjunction with the firm ViaCyte and looks at Encapsulated Beta Cell Replacement Therapy for Diabetes. (This look like an IDDP but my reading of the release is not clear. I will see if I can get confirmation.) Yes it is in fact an IDDP* From the Release:

Existing cell therapies such as islet and pancreas transplantation have the potential to cure T1D by restoring normal islet function and normalizing blood glucose levels in people with T1D. Because the number of cadaveric human donors for pancreatic islets is limited, ViaCyte’s program will provide a replenishable supply of functional insulin-producing cells. Furthermore, packaging the cells in a device (“encapsulation”) creates a physical barrier around the cells and has the potential to protect the transplanted cells from immune rejection, and may eliminate the need for chronic immunosuppressive drugs. The ultimate goal of this partnership is to help patients with T1D restore their ability to regulate blood glucose, thereby reducing or eliminating the need for constant self-management and administration of insulin.
The three-year series of preclinical studies being co-funded by JDRF will help ViaCyte prepare the information necessary to apply for regulatory approvals to study the system for safety and efficacy in people with T1D.

For more see JDRF's New Room online.

Why these matter:

Most folks living with type 1 are adults. Our first goal as parents of T1D kids is to have the grow to be T1D adults pursuing their lives interest. I have heard the figure tossed around that 85% of T1Ds are adults, seems about right. So it only makes sense to study how to keep T1D adults health.

Cure can mean a lot of different things to different people. To me, in the broadest sense it is to return the biological production of insulin. That may or may not include turing off the autoimmune response that killed off the beta cells in the first place and from the little (very little) I know of how immunity works that is no small think. Encapsulation get around that problem with magic star tech like shields that protect the Starship Insulin-producing-cell from attack by evil T cells. ... or something like that. Getting beta cells is no easy matter either. This project addresses both the shield and production of beta cells form stem cells. May the Force be with you, wait wrong sci-fi flick but you get the point and the point is Live Long and Prosper.

*For some background on IDDP you can see earlier post in YDMV. 
http://www.ydmv.net/2007/07/over-last-few-months-i-have-seen-number.html
http://www.ydmv.net/2007/10/apparently-somebody-does-know-how-this.html
http://www.ydmv.net/2007/10/5-easy-pieces.html