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Final piece of type 1 diabetes puzzle solved

Scientists say new findings could transform care and treatment of the condition

Mark Gould

Monday, 25 April 2016

Scientists say they now have a complete picture of the areas that the immune system attacks to cause type 1 diabetes. They are hopeful that their findings will help transform care of patients with the condition.

A study,* published in the journal Diabetes, discovered that the protein membrane tetraspanin-7 is the fifth and final critical target at which the damaged immune system takes aim. This one final element has proved elusive for two decades. The charity Diabetes UK has described the findings as "impressive".

Studies looking at the unique antibodies made by patients with type 1 showed there were five key targets that the immune system attacked - insulin, glutamate decarboxylase, IA-2, zinc transporter-8, and the final piece of the puzzle, tetraspanin-7. But working out exactly what they were has been like identifying someone from their silhouette.

Dr Michael Christie, who led the research at the University of Lincoln, told the BBC: "With this new discovery, we have now finished identifying what the immune system is targeting - we have the complete picture."

Knowledge of some of these targets is already being used in a trial at King's College London that is aiming to stall the progression of type 1. But Dr Christie says having the complete picture could help transform care for type 1 patients.

He said: "Once the immune system decides it wants to get rid of something it's very hard to stop, so diabetes has proved to be a difficult disease to prevent.

"So we're hoping that, by having identified the major targets in the disease, we can find ways to prevent it by blocking the immune response to these five proteins without leaving that person vulnerable to infections.

"With recent improvements in our understanding of the disease I'm very hopeful we'll develop a treatment now; I have a lot more confidence than even five years ago."

* McLaughlin KA, et al. Identification of Tetraspanin-7 as a Target of Autoantibodies in Type 1 Diabetes. Diabetes 7 March 2016. doi: 10.2337/db15-1058

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