Dr Richard Oram, University of Exeter
Professor Yuval Dor, Hebrew University of Jerusalem
Type 1 diabetes (T1D) was thought to involve total destruction of insulin producing pancreatic beta-cells by the immune system. We have recently shown, using a novel and highly sensitive test for insulin, the existence of working beta-cells in most patients even may years after diagnosis of T1D. This could result from either escape of some cells from autoimmune destruction, or a continuous regeneration and destruction of beta cells. Either possibility may transform our understanding of T1D and approaches to a cure.
A prediction of the regeneration-destruction model is that long standing T1D patients have ongoing beta-cell death. We have developed a new blood test that can detect cell death in specific human tissues, and propose to utilize this technology to address the fundamental question: is there beta-cell turnover in long standing T1D patients?
The aims of the proposed research are:
1. To collect blood samples from long standing T1D patients showing different levels of preserved beta cells.
2. To optimize our blood test for detection of cell death for these long duration patients
3. To determine the levels of beta-cell death as well as other tissues in long standing T1D patients
This study will answer a critically important question: Are beta cells constantly dying and regenerating in long duration T1D. If this is the case this will open the possibility of finding regenerative interventions many years from diagnosis. In addition, the sensitive assay developed and employed in this study will provide a novel tools for disease diagnosis and monitoring, and information about further events of tissue damage in T1D patients, such as vascular complications.