This Diabetes Week, new research we funded has uncovered nine ‘core’ genes that are central to the development of type 1 diabetes.
The genes are all linked to the immune system. They reveal new interactions in the immune system that contribute to the attack on the pancreas. These newly discovered immune processes hold great potential to be new targets for immunotherapies to prevent, delay or treat type 1 diabetes.
The causes of type 1 diabetes include a complex mix of genetic factors in combination with environmental triggers. Scientists have previously found many individual genes that have a very small, added-up effect on type 1 diabetes risk.
Knowing more about genes linked to type 1 diabetes, and the exact processes inside the body they control, can reveal new insights into how and why type 1 diabetes develops, and where to intervene to stop it.
The major and minor players
In the new study, published in the American Journal of Human Genetics, researchers led by Professor Helen Colhoun and Professor Paul McKeigue at the University of Edinburgh developed a new method of analysing how different genes impact your risk of developing type 1 diabetes.
Their aim was to identify which genes are at the root of type 1 diabetes risk, and which genes only have small effects.
The team examined genetic data from almost 5,000 people with type 1 diabetes and 7,500 people without type 1 diabetes, as well as analysing blood samples.
What they found
By looking at how genes control the activity of other genes, the team pinpointed, for the first time, nine new ‘core’ genes. They are all linked to the immune system, and directly and powerfully affect type 1 diabetes risk.
Seven of these genes play a crucial role in controlling the immune cells responsible for attacking the pancreas in type 1 diabetes.
Two of the genes are linked to part of the immune system’s first line of defence. This is responsible for detecting threats, like bacteria or viruses, and launching an immediate attack. This part of the immune system has not previously been associated with type 1 diabetes.
Targeting new lines of attack
The new processes in the immune system brought to light could in future help scientists to develop new immunotherapies – treatments that work to re-programme the immune system – that target these.
The first ever immunotherapy – teplizumab – was approved for use in the US last year. It can delay the onset of type 1 diabetes for up to three years. But, for everyone at risk of, or affected by type 1 diabetes to benefit, we need an armoury of treatments that can target the immune system’s many lines of attack.
The researchers hope their findings will lead to new treatments that could:
- Prevent the immune system attack that causes type 1 diabetes
- Further delay the onset of type 1 diabetes in those at high risk
- Preserve beta cells that survive the immune attack following a diagnosis of type 1 diabetes.
Dr Elizabeth Robertson, Director of Research at Diabetes UK, said:
“Type 1 diabetes is a constant balancing act of blood sugar checks and insulin injections. We desperately need to find ways to prevent, delay and treat the condition, to spare hundreds of thousands of people the burden of managing their diabetes day in, day out.
“This research has broken new ground in our understanding of genes that underpin type 1 diabetes, and how they contribute to the immune attack that causes the condition. The discovery that these core immune system genes are central to the development of type 1 diabetes opens the door to a raft of new targets for immunotherapies that could prevent, delay or treat type 1 diabetes early on.
“With the first ever type 1 diabetes immunotherapy approved for use in the US last year, we are on the brink of a new era for type 1 diabetes therapies that could see it transformed from a lifelong condition to one that can be prevented, treated and ultimately cured.”
