A study from the University of Cambridge JDRF/Wellcome Trust Diabetes Inflammation Laboratory at the Cambridge Institute of Medical Research led to the proposition of a new drug to regulate the type 1 diabetes autoimmune response: aldesleukin, a recombinant version of interleukin-2 (IL), a cytokine that wears many hats in the immune system. Aldesleukin is currently approved by the Food and Drug Administration (FDA) to treat melanoma and renal cell carcinoma in high doses.
“The current treatment [for type 1 diabetes] - multiple daily injections of insulin - are at best inconvenient, at worst painful, particularly for children," says Dr Frank Waldron-Lynch, who led the study. "Our goal is to develop a treatment that could see the end to the need for these life-long, daily injections by curtailing the early damage caused by the patient's own immune system.”
Waldron-Lynch and his team conducted their study to measure the ability of aldesleukin to regulate the immune response, using lower doses than the drug is currently used for to treat cancer. In the case of type 1 diabetes, aldesleukin works by enhancing the activity of regulatory T cells, which can limit the immune responses in autoimmune reactions.
The results from extensive immune monitoring in 40 patients showed that the doses increased the level of regulatory T cells by 10-20 percent, the minimum needed to prevent an immune attack on insulin-producing cells and the maximum level to leave the effector immune cell activity intact in order to keep the rest of the body protected from infection.
Additionally, the results suggest that the drug shouldn’t be administered on a daily basis, so regulatory T cells won’t lose any sensitivity to aldesleukin.
"Our work is at an early stage, but it uses a drug that occurs naturally within the body to restore the immune system to health in these patients,” Waldron-Lynch said. “Whereas previous approaches have focused on suppressing the immune system, we are looking to fine-tune it.”
In the future, Waldron-Lynch and the team plan on focusing the new aldesleukin-based treatment on people newly-diagnosed with type 1 diabetes who are still able to produce some insulin from beta cells. The study was recently published in PLOS Medicine.
Sources: University of Cambridge, American Diabetes Association, National Cancer Institute, Cytokine