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New diabetes treatment foreseen

White blood cell has key role, study finds

Researchers at the McGill University Health Centre have discovered exactly how some children develop juvenile diabetes, raising hopes of a new targeted treatment for the disease.

Led by immunologist Ciriaco Piccirillo, the researchers found a specific type of white blood cell - called CD4+Treg - acts as a brake on the immune system, ensuring it doesn't go haywire.

In people suffering from Type 1 diabetes, however, the CD4+Treg cells don't work properly, setting the stage for the immune system to attack within, destroying the insulin-producing capability of the pancreas.

More than 2 million Canadians suffer from diabetes. Most develop obesity-related, or adult-onset, Type 2 diabetes. About 10 per cent of diabetics have the Type 1 disorder, which requires frequent injections of insulin daily to break down blood sugar.

Some Type 1 diabetics also take immuno-suppression drugs, which have harsh side effects and make the patient susceptible to infection. Piccirillo, however, said his discovery could lead to immuno-suppression therapies that are targeted toward the pancreas, leaving the rest of the immune system intact.

"The real challenge for state-of-the art medical immunology is how to develop organ-specific immuno-suppression," Piccirillo said in an interview. "We think this type of study opens up a new corridor to unravel some of the factors to turn on or off that specific (CD4+Treg) cell switch."

In other words, by applying the brake, such therapies would cause the immune system to stop attacking the pancreas's insulin-producing beta cells.

The McGill team made its discovery by studying laboratory mice genetically engineered to develop Type 1 diabetes. But other genetic studies have shown the same CD4+Treg mechanism also works in humans.

The McGill study, funded in part by the Canadian Institutes of Health Research, appeared this month in the journal Diabetes.