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Cure

CureType 1 diabetes (T1D) occurs when the body's own immune system misguidedly attacks and destroys certain cells in the pancreas, an organ about the size of a hand that is located behind the lower part of the stomach. These cells – called beta cells – are contained, along with other types of cells, within small clusters in the pancreas called islets. Beta cells normally produce insulin, a chemical messenger that helps the body move sugar from food sources into cells throughout the body, which use it for fuel to stay alive. But when the beta cells are destroyed, no insulin can be produced, and sugar stays in the blood instead, where it can cause serious damage to all the organ systems of the body and starves cells of their normal energy source. For this reason, people with T1D must routinely inject insulin in order to stay alive.

The Basic Challenges of Curing Type 1 Diabetes

 

Healthy Person with Normal Pancreas

Type 1 Diabetes Disease Process

The Basic Challenges of Curing Type 1 Diabetes

 

Healthy insulin-producing
beta cells

Above, right:

1. Red arrows show misguided immune attack on the pancreatic beta cells.

2. Dark circles show the dying insulin-producing beta cells.

3. Insulin production declines & blood sugar levels rise too high.


JDRF CURE Research Goal: Restore and Maintain Normal Pancreas Function

To cure someone diagnosed with T1D, two fundamental aspects of the disease need to be corrected. First, we need to find ways to turn off the misguided immune system attack on the insulin-producing beta cells; stopping the autoimmune process, or protect new beta cells from this ongoing attack (encapsulation). Next, we need to find a way to restore the body's ability to produce its own insulin. Restoring new insulin-producing cells in the body could be achieved in a few different ways – either by making them from other remaining healthy cells in the pancreas (regeneration), or by making them in a lab or obtaining them from other animals and putting them into the body (replacement).  

Approach Without Immune Therapy

 

Approach With Immune Therapy

Approach Without Immune Therapy

 

Approach With Immune Therapy

1. Body's misguided attack on pancreas continues

2. Form an immune protective barrier around beta cells from another source

3. Replace beta cells by implanting the protected new beta cells.

 

1. Stop body's misguided attack on pancreas, AND

2a.  Regenerate new beta cells from those remaining, OR

2b. Reprogram other cell types into growing new insulin-producing beta cells, OR

2c. Replace beta cells by implanting new ones.


JDRF Immune System and Beta Cell Measurement and Imaging Tools

At the intersection of beta cell and autoimmune research to find a cure for T1D, is the critical need for better tools to define the onset of the disease and to predict or track disease progression and responses to new therapies. Such tools would address a critical gap in the field and help shorten clinical trials of new therapies. Current tools have restricted predictive power and limited acceptance by regulatory agencies. T1D autoimmunity-related tools are required for:

  1. staging the onset and progression of the autoimmune response associated with the disease;
  2. identifying appropriate subjects for clinical trials; and
  3. providing endpoints of effectiveness in clinical trials that respond more quickly to new therapies.

The detection of changes in beta cell stress, destruction, and regeneration will be useful both as predictive markers for T1D as well as markers of the effectiveness of new therapies aimed at relieving beta cell stress and destruction or aimed at promoting beta cell regeneration. Many of these new tools may be found by closely following people with T1D over time as their disease progresses in so-called "natural history" studies.