Tailored treatments for type 1 diabetes? 30 June 2021 Professor Ed Stanley is working with stem cells to try to find the cause of type 1 diabetes and develop better treatments Through stem cell research, Professor Ed Stanley, head of the Immune Development Laboratory at Murdoch Children’s Research Institute, is hoping to gain a better understanding of the causes of type 1 diabetes, as part of the Diabetes Australia Research Program. Professor Stanley is hoping his research will lead to better treatment of the condition. In type 1 diabetes, the cells that produce insulin in the pancreas are destroyed by the immune system, but researchers still don’t understand why. “We don’t know whether the issue is with the immune system or whether it’s actually the cells that make insulin that are the problem,” Professor Stanley says. He says one of the reasons researchers still don’t understand the cause of type 1 diabetes is because the only way to study human insulin-producing cells has been through organ and tissue donations, but most of these donors don’t have type 1 diabetes and if they do, they have almost no insulin-producing cells left. “But over the past few years, a number of groups around the world have figured out a way to work-around this problem by using stem cells to make those insulin-producing beta cells in the lab,” he says. Companies around the world are looking at transplanting these laboratory-made beta cells into people with type 1 diabetes, but Professor Stanley admits that while it’s a promising area of research there are issues with it. Professor Stanley’s own research is focused on why the immune system is attacking these cells. “We have to get the immune cells from the same people that we got the sample from to make the beta cells, and then match them up.” In collaboration with other clinicians at Murdoch Children’s Research Institute and Associate Professor Stuart Mannering at St Vincent’s Institute of Medical Research, he has managed to make stem cells from type 1 organ donors, turn them into insulin-producing cells and then, through grants, including one from Diabetes Australia in 2019, produce immune system cells to match up with the insulin-producing cells. “Our aim is to try to get all these bits and pieces together so that all the cells can talk to each other. That way, we think we’ve got a better hope of understanding what these cells are actually seeing when they see there’s something wrong.” In the future, Professor Stanley says different problems may happen for different people. “It might be that the blanket description of type 1 gets broken down into multiple sub-groups that all have their own separate causes, and we can then look for more specific treatments.” This may mean scientists will be able to stop the condition from progressing. A type 1 diabetes diagnosis is usually made when there are still some functioning insulin-producing cells in the pancreas. “If you could stop the condition at that point, maybe those people wouldn’t need insulin injections, or they’d only need them sporadically. There’s a window where, if we could get in and turn things around, we could have a big impact on people’s futures.” Professor Stanley says they’re aiming to get cell samples from newly diagnosed children, which can be taken from a single plucked hair. They can then make insulin-producing cells and immune cells in the lab from these samples. Professor Stanley says while there is a long road ahead in type 1 diabetes research, a lot of progress is being made. “The science is very slow, people with type 1 know the cure has been ‘just around the corner’ for 50 years – but the progress is fast. We haven’t got to the end yet because it’s a complicated condition. I’m optimistic that we will find better ways of treating type 1.”
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