A major shift in the way patients with type 1 diabetes are treated could be on the horizon – with scientists at the Institute of Immunity and Transplantation (IIT) at the forefront of this vital work.

Type 1 diabetes is an auto-immune disease in which the body’s own immune system attacks the cells in the pancreas that produce insulin. 

For the past 100 years, the only treatment available has been insulin, which needs to be injected multiple times a day, creating a significant burden for those with the condition. 

But there could now be a breakthrough on the horizon. Around the world, a number of clinical trials are underway testing whether immunotherapy could be used to effectively treat type 1 diabetes.

Immunotherapy works by manipulating the immune system so that it no longer attacks and destroys the insulin-producing cells in the pancreas. 

Lucy Walker, Professor of immune regulation at the IIT in the Pears Building, has a study underway which will look at whether combining two types of immunotherapies could work together as an effective treatment. 

The study will look at whether a drug called Abatacept, which is used to treat other autoimmune diseases, could be combined with a second drug - low-dose of interleukin-2 – in order to improve its effectiveness. 

It is hoped that the two drugs together would suppress the body’s T-cells, which are responsible for destroying the insulin-producing cells in the pancreas, while also preserving T-regulatory cells. 

The T-regulatory cells have an important role in helping to dampen down the body’s immune response, telling it not to destroy the body’s own tissues so it is important that they are preserved.     

The therapy has the potential to prevent type 1 diabetes occurring or reverse the onset in people recently diagnosed and who still have some insulin-producing cells.

Professor Walker is collaborating on this study with Dr Danijela Tatovic at Cardiff University, with funding from the Steve Morgan Foundation, Diabetes UK and JDRF.

In the new year, 12 adults from the Royal Free Hospital and University Hospital Wales will be recruited to the study - the participants will need to have been diagnosed within the last three months to five years. 

Professor Walker said: “For the last 100 years all we have been able to do to treat type 1 diabetes is give insulin. We haven’t attempted to interrupt the disease but now we’re looking to do exactly that. 

“We’re hoping to get a lot of important information out of this study, by giving people the combined immunotherapy then monitoring them closely – for example taking regular blood samples – to give us an in-depth understanding of how these treatments are affecting their different immune cell populations.

“If the drugs work together in the way we predict from our laboratory experiments, the information from this study will be important in helping us design a much larger clinical trial.”