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Are two immunotherapies better than one?

Project summary

Abatacept is a type of immunotherapy that scientists have found can help to slow down the immune attack and the progression of type 1 diabetes in people newly diagnosed. But in doing so, Abatacept reduces ‘friendly’ immune cells, which are a vital part of a healthy immune system. Professor Walker thinks she can stop this from happening – and boost the effectiveness of Abatacept – by combining it with another drug. She’ll test this combination therapy in mice to get important evidence that could lead to clinical trials in people with type 1 diabetes and help get this treatment licenced.

Background to research

In type 1 diabetes, the immune system attacks and destroys insulin-producing beta cells in the pancreas. Scientists are testing out new treatments – called immunotherapies – that work by retraining the immune system so that it no longer destroys beta cells. In the future, immunotherapies could be given to protect beta cells and slow the immune attack in people who’ve just been diagnosed or could be given earlier to prevent the condition entirely.

One type of immunotherapy, called Abatacept, has already shown promise in clinical trials. Results showed people recently diagnosed with type 1 who received Abatacept produced on average 60% more of their own insulin compared to people who received a placebo drug.

However, Abatacept also reduced important immune cells, called regulatory T cells (or Tregs). Tregs are responsible for policing the immune system and making sure it doesn’t attack healthy cells, so we need the right balance of them.

Professor Lucy Walker has found a way in mice to prevent this loss of Tregs, and make Abatacept work better, by combining it with another drug that is also being tested in people with type 1 diabetes. They’ve found that the combination of the two immunotherapies can prevent the development of type 1 diabetes in mice.

Research aims

Professor Walker now wants to build on this research and test if this drug combination can also help mice who already have type 1 diabetes. Her team will monitor levels of Tregs and insulin production in mice who receive the drug to check if it helps to improve or reverse type 1 diabetes.

Professor Walker’s team will also explore in detail how this drug combination works and if there are any biological signals that could help scientists predict who is likely to benefit most from the treatment. This understanding will be vital to help advance research and get treatment tested in trials with people with type 1 diabetes.

Potential benefit to people with diabetes

This project could help scientists to make a promising breakthrough treatment even more effective and reignite research into it. Immunotherapies hold huge promise to slow the progression of type 1 diabetes in people who are at high risk or recently diagnosed, bringing us closer to preventing and curing type 1 diabetes.

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