Type 1 diabetes study points to new treatments

New research is producing results for a team at the University of Virginia studying type 1 diabetes.

CHARLOTTESVILLE – Scientists at the University of Virginia recently completed the largest and most diverse genetic study of type 1 diabetes never undertaken.

Through the study, the researchers identified new drug targets to treat the disease, which affects 1.6 million American adults and children.

According to a Study 2017-18 the Virginia Department of Health published, type 1 diabetes accounts for only five percent of all diabetes cases in the United States.

What is type 1 diabetes?

You’ve probably heard of diabetes. But did you know that there are two types?

As a rule, people with Type 2 diabetes have the ability to rid their bodies of the disease. Often times, treatment involves lifestyle changes, such as diet and exercise.

For those with type 1 diabetes, there is no cure. However, people with the disease manage their condition with insulin.

Dr. Stephen Rich, one of the study researchers, is the director of the Center for Public Health Genomics within the University of Virginia School of Medicine. He is also professor of public health sciences and professor of biochemistry, microgenetics and biology.

Rich explained that the immune system is responsible for type 1 diabetes. Normally, the immune system fights viruses and pathogens. With type 1 diabetes, instead of attacking the virus or pathogen, the immune system attacks the body.

“There is a whole host of autoimmune diseases. Type 1 diabetes is probably the most common, but it is also rheumatoid arthritis, juvenile idiopathic arthritis, lupus, inflammatory bowel disease. There’s a whole series of myasthenia gravis, multiple sclerosis, ”Rich said. “And in fact, these autoimmune diseases tend to cluster together. So sometimes you can have families where someone has type 1 diabetes and a family member can have autoimmune thyroid disease like Graves disease or Hashimoto’s thyroiditis or whatever.

For people with type 1 diabetes, their bodies attack and destroy the insulin-producing beta cells.

“There is no insulin production and because there is no insulin production, insulin is what translates glucose into energy for the body. So when there is no insulin, the body attacks its own cells, systems and organs to try to get that energy, ”says Rich. “And that’s why without insulin people die.”

A large study

The UVA research team doubled participation in the largest previous study on type 1 diabetes. They ultimately looked at 61,427 people of North European, African, Asian and Latino descent.

Rich explained how studying tens of thousands of participants helped shape the research.

“There are a few approaches that we use in genetics to try to identify what factors in the genome really affect disease risk. One of these approaches is called genome-wide association analysis. And so you have sites in the genome, along the entire genome, ”Rich said. “We have done this previously and identified about 40 areas that were important.”

The professor compared the information gleaned from genomes to knowing someone lives in Charlottesville, but not knowing what house they reside in.

The large participation helped the team identify a narrower region in which to search for specific genetic variants. It also gave the team significant opportunities to identify more areas of the genome out of the 186 regions.

In total, the scientists identified 78 regions on the chromosomes where genes reside, which influence the risk of type 1 diabetes. Of these, the researchers found 36 previously unknown regions.

New discoveries

Researchers have identified specific and natural genetic variations that influence risk. They also determined how these variations act on particular types of cells. Using their findings, the team identified and prioritized potential drug targets.

Drugs targeting 12 genes identified in the diabetes study are underway or scheduled for clinical trials for autoimmune diseases. This could speed up the reuse of drugs to treat or prevent type 1 diabetes, the researchers say.

“One of the beautiful things that has happened over time is that there has been a whole series of drugs developed for autoimmune diseases. And so there is a drug based on an interleukin 23 alpha gene that is available for rheumatoid arthritis, and it seems to be working well, ”Rich said. “Previously the gene for rheumatoid arthritis – it’s one of many genes for rheumatoid arthritis – but this gene was not a type 1 diabetes gene. But with our study, we now find that it is is the case. And if all of a sudden we have drugs for other autoimmune diseases that are on the market that are being used that haven’t been used before for type 1 diabetes. Now that points to drugs that might be. used. “

Rich spoke about Yale University The discoveries of Professor Kevan Harold delay the onset of type 1 diabetes by almost two years.

“This suggests that there are compounds based on the immune system. And it’s a lot of our genes that we’re discovering, including this IL23A gene, that could be used now to slow progression and, in fact, maybe. even slow it down enough that it doesn’t happen, “Rich said.” And so if you can intervene early enough with those at risk, then that’s important. “

Amie Knowles reports for The Dogwood. You can reach her at ami@couriernewsroom.com