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Searching for clues on the origins of type 1 diabetes

Our researchers have been looking into whether stressed-out insulin-making cells in the pancreas can trigger the immune attack behind type 1 diabetes.

In type 1 diabetes, the immune system attacks and destroys insulin-making beta cells. But scientists aren’t sure if the immune system‘s attack on beta cells is entirely unprovoked or whether beta cells are playing a part in triggering their own downfall. In a new study, our researchers have been looking for clues to find out.

Understanding more about why the immune system starts attacking beta cells could help scientists to develop new treatments designed to prevent or slow type 1 diabetes, which could one day form part of a cure.

Most children under the age of six months who are diagnosed with diabetes have a rare type called neonatal diabetes. Like type 1 diabetes, this means they are not able to produce enough of their own insulin. But unlike type 1 diabetes, where the immune system destroys the beta cells, in neonatal diabetes a single genetic spelling mistake causes beta cells to become so stressed they start to self-destruct.

Baby beta cells

A team, including Diabetes UK-funded researchers Drs Richard Oram and Matthew Johnston at the University of Exeter, studied babies with neonatal diabetes to explore if the immune system sees these stressed beta cells as a problem, and if this plays a role in their destruction.

The team tested samples from 242 babies with neonatal diabetes to look for signs of an immune attack, called autoantibodies. Autoantibodies are molecules made by the immune system which stick to certain cells. They act like targets to show killer immune cells which cells to attack. We can test for autoantibodies to see if the immune system has started to plan an attack on beta cells in the pancreas.

In the largest ever study to look at this, the team found it was rare for babies with neonatal diabetes to have beta cell autoantibodies. This suggests that beta cell stress on its own does not trigger the immune system to attack these cells. The results help us understand more about type 1 diabetes by suggesting that the immune system’s attack is not influenced by the stress levels of beta cells  

As a next step, the researchers plan to look for any links between beta cell stress and the activity of killer immune cells (known as T cells), which are responsible for directly destroying beta cells in type 1 diabetes.

Ruling out culprits

This study helps to shed light on a key unanswered question by suggesting beta cell stress is unlikely to be a key player in the immune attack behind type 1 diabetes.

It’s crucial for researchers to look into the nitty gritty of how and why type 1 diabetes develops. Being able to zero in on the triggers of the immune attack will pave the way for new treatments that slow or prevent type 1 diabetes. And understanding which processes aren’t responsible can be just as helpful as knowing which are, as scientists work towards this goal.

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