Professor Shane Grey: Protecting insulin-producing cells from immune attack
Type 1 diabetes (T1D) is a lifelong autoimmune condition that occurs when the body’s immune system mistakenly attacks the insulin-producing cells in the pancreas.
One of the most exciting areas of T1D research is the discovery of therapies that can protect these cells, but researchers face the challenge of delivering these therapies to where they are needed in the body.
Prof Grey from the Garvan Institute of Medical Research is working on an innovative way around this problem. He is investigating a way to deliver A20, a key protein that can help protect insulin producing cells against immune attack, to exactly where it is needed.
Prof. Grey’s research is in its early discovery phase, but if successful, could mean that insulin-producing cells are protected for longer which could delay T1D symptomatic onset – a gamechanger for the T1D community.
Professor Jenny Couper: Understanding how the environment influences T1D onset
The Environmental Determinants of Islet Autoimmunity (ENDIA) Study, led by Professor Jennifer Couper and funded by JDRF, is designed to determine what
environmental factors influence the onset of T1D and help inform ways to prevent it.
In Australia, T1D in children is twice as common as it was 20 years ago. This is because the environment has changed. If we can understand exactly what in the environment contributes to, or protects against the condition, those factors can be modified or avoided to prevent T1D onset.
First established in 2015, ENDIA is a world first program that monitors select subgroups including both pregnant women and expectant fathers with T1D, babies from either of these groups up to the age of six months, and siblings in families with a close T1D connection.
The study monitors and collects samples and data to investigate over 500 types of potential environmental triggers that may contribute to T1D onset, such as viruses, gut bacteria and potential heavy metals and toxins in the environment.
The study has followed 1500 individuals across Australia and to date, 17 children participating in ENDIA have been diagnosed with T1D and more than 40 have been identified as being at risk. Over 22 publications from the study are having a major impact on our understanding of newly identified T1D triggers and are informing new approaches to treatment.
Prof. Couper says that “The goal of ENDIA is to understand the environmental exposures in early life that drive the onset of type 1 diabetes."
“We’ve already seen that building on this body of knowledge is key to informing the development of therapies and interventions we can then test in pregnancy and during the first years of life, to ultimately decrease the risk of developing the condition.”
Professors John Wentworth and Peter Colman: Screening to detect onset of T1D
The work of Profs. Wentworth and Coleman involves screening individuals at risk of T1D for newly identified islet autoantibodies (IAs) present in the blood. These IAs are a very early sign that the body’s immune system is attacking insulin-producing cells in the pancreas.
This means that long before any clinical signs or symptoms of T1D appear, the condition can be more accurately diagnosed than it is currently, therefore treatment can begin sooner.
The major advantages of this include being able to avoid the effects of sudden, shock diagnoses that are often accompanied by serious illness as well as longer-term complications like impaired vision, nerve damage and increased risk of cardiovascular disease.
Prof. Wentworth says that “Early diagnosis of type 1 diabetes is really important. It allows us to monitor children for signs of progression and, if this occurs, to start insulin injections in good time and prevent serious illness.
“This is what the Type1Screen wants to achieve. We have just rolled out finger prick tests that families can perform at home and mail back to the lab, which means we can get results to families sooner than we could before."
“Our hope is that the this will make it much easier for families to access screening, particularly those living in regional communities."
“Ultimately, we want to make screening accessible to every Australian child. Type1Screen will take us closer to this goal by demonstrating to the world that we can perform cheap and accurate screening in a timely manner and at scale.”