December 2008 eUpdate
INTERLEUKIN-2 PROTEIN MAY BE AT FAULT FOR CAUSING TYPE 1 DIABETES Qizhi Tang, PhD and her colleagues have known through animal studies that diabetes is caused by an imbalance in the number of immune cell populations – effector “bad” T cells increase while regulatory “good” T cells decrease. In research published in the journal, Immunity , Dr. Tang and her team explain that a protein produced by the regulatory T cell, Interleukin-2 (IL-2), appears to be the reason why these T cell populations are out of balance. When IL-2 is found in low levels in the pancreas, regulatory T cell numbers have declined due to cell death and insulin-producing beta cells have been destroyed. By giving low-dose treatments of IL-2, the number of regulatory T cells increase and the beta calls are protected, thus preventing the disease. As this research continues in animal and eventually human studies, it may be possible for clinicians to stimulate the immune system instead of suppressing it to treat autoimmune diseases such as type 1 diabetes. [ journal article ] [ JDRF story ]
PHYSICIAN RESEARCHER LEADS NATIONAL STUDY TO STOP BETA CELL DESTRUCTION UCSF Pediatric Diabetes Program Director Steve Gitelman, MD has partnered with the Immune Tolerance Network (ITN) to launch a study involving ATG , or anti-thymocyte globulin, to see if this drug can halt the progression of new onset type 1 diabetes. The START trial (Study of Thymoglobulin to Arrest Type 1 Diabetes ) hopes to recruit 66 volunteers, 18 – 35 years of age, within six weeks of diagnosis. Thymoglobulin, an FDA-approved drug used in organ transplantation, has been used to treat autoimmune diseases such as multiple sclerosis, rheumatoid arthritis and lupus. It is suspected that it may work in diabetes in at least two ways: by eliminating destructive immune cells from the bloodstream, or by changing how the remaining immune cells work. The START trial will test whether Thymoglobulin can “reset” the immune system so that immune cells accept the beta cells rather than continue to attack them. [ website ] [ JDRF story ]
ER STRESS IN BETA CELLS MAY HELP TO CAUSE TYPE 2 DIABETES Diabetes Center researcher and San Francisco General Hospital endocrinologist Feroz Papa, MD, PhD is fascinated with the emergency care that is provided by a cell’s endoplasmic reticulum (ER) – coincidentally the same abbreviation and even the same function as an emergency room of a hospital. The ER isolates sick proteins in the cell and attempts to revive them. Dr. Papa believes that during the gradual development of type 2 diabetes, the stress of processing large amounts of insulin will stress the ER of the beta cell. Eventually the ER sends out death signals that results in beta cell destruction and eventually type 2 diabetes. Fortunately for some, there is a protective mechanism that kicks into gear. Dr. Papa hopes to learn why this protective mechanism varies by individual so he can help identify new drug therapies for type 2 diabetes. Learn more about this research in two recent news stories. [ story ] [ podcast ]
STEM CELL RESEARCH: TRANSFORMING MEDICINE On November 20th , UCSF held a panel discussion on stem cell research that was moderated by KQED Radio’s Michael Krasny, PhD. Diabetes Center researcher Matthias Hebrok, PhD joined an esteemed group of stem cell researchers to discuss the potential of stem cells to cure disease. [story] [ Forum, KQED ]
SAVE THE DATE – 2009 PEDIATRICS AND ADULT PATIENT SYMPOSIUMS The annual UCSF Pediatric Diabetes Symposium & Kids Kamp is being held on Saturday, February 28, 2009, 9 a.m. – 3 p.m., at the UCSF Mission Bay Campus in San Francisco. The annual UCSF Diabetes Teaching Center’s Adult Patient Symposium is being held on Saturday, April 4, 2009, 7:45 a.m. – 12:30 p.m., at the UCSF Laurel Heights Campus in San Francisco. More information on these educational programs will be provided in future issues of eUpdate. In the meantime, videos of previous symposiums can be found on our website. [pediatric] [ adult ]
MAKE A NEW YEAR’S RESOLUTION TO SIGN UP FOR A DIABETES EDUCATION CLASS Whether you are newly diagnosed or simply in need of more information to manage your diabetes, the UCSF Diabetes Teaching Center (DTC) can help. As one of the country’s oldest diabetes education programs, the DTC offers classes for individuals with type 1 and type 2 diabetes. Diabetes management is a lifestyle, and while we understand it is not a lifestyle that you would have chosen, it is one that you can master to stay healthy. For more information, call 415-353-2266. [ classes ] [ class schedule ] [ website ]
The Diabetes Center at UCSF is among the premier institutions for clinical trials of emerging therapies in diabetes. Numerous clinical trials in type 1 and 2 diabetes are now underway.
Interested in participating? A sample of our trials currently enrolling patients:
Type 1 Diabetes: TrialNet Natural History Study [Antibody Screening] Seeking relatives of people with type 1 diabetes to find out if these family members are at risk for developing diabetes [ more ]
Type 1 Diabetes: Islet Transplantation with Raptiva Seeking volunteers 18 and older, with type 1 diabetes and weighing less than 175 lbs [ more ]
Type 1 Diabetes: Teplizumab (HOKT3y1 (Ala-Ala)) [Protégé Study] Seeking volunteers, 16 to 35 years of age, within 12 weeks of diagnosis [ more ]
Type 2 Diabetes: Paleolithic-Type Diets and Metabolic Control Seeking volunteers 18 years of age and older with type 2 diabetes [ more ]
Non-Diabetics: Chromium and Insulin Resistance Seeking volunteers 20 to 50 years of age, not exercising regularly, and of normal body weight [ more ]
Year-End Message from Diabetes Center Director, Dr. Jeffrey Bluestone
It is hard to believe that soon we will be entering the final year of this decade -- and nearly nine years since we launched the Diabetes Center at UCSF. Thanks to the talented team we have assembled – and your support -- we have made significant progress in preventing, treating and curing diabetes.
As you know, we’ve moved much of our research from the lab into the clinic, launching multiple clinical trials in type 1 and type 2 diabetes. We continue to be involved in efforts to bring the first immunotherapeutic to the treatment of type 1 diabetes (anti-CD3). Furthermore, we are testing novel immunomodulatory compounds (Thymoglobulin, Rituxan, Orencia) in the early stages of the disease.
Through our team of research immunologists, we continue to make exciting progress in developing new treatments to protect beta cells from autoimmune destruction in animals. In addition, we’ve had one of the highest success rates in islet transplantation thanks to our new drug protocols to prevent rejection. And, lastly, after years of partnering with the stem cell engineering company, Novocell, our pancreatic development researchers expect to take stem cells into the clinic within a few years.
At this time I’d like to thank our extended family – patients, donors, and all of our friends throughout the world – for your support. On behalf of the faculty and staff of the Diabetes Center at UCSF, we wish you the healthiest and happiest holiday season.
Jeffrey A. Bluestone, PhD, Director, Diabetes Center at UCSF
If you wish to include the UCSF Diabetes Center in your year-end giving plans, please feel free to visit our donation website and designate your gift to "The Diabetes Center", or contact Kevin McAteer at 415-476-3627; firstname.lastname@example.org.
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