Immunotherapies are treatments that re-programme the immune system so that it no longer attacks and destroys insulin-producing beta cells in the pancreas. In the future, they could stop Type 1 diabetes in its tracks or prevent the condition entirely.
Immunotherapies are already used to treat other autoimmune conditions, such as psoriasis and rheumatoid arthritis. We’re funding research that’s aiming to do the same for people with Type 1 diabetes.
From trials to treatments
Before new immunotherapies can reach people with Type 1 diabetes, scientists need to find out if they are safe and effective. To get us there faster, we established a network of scientists and research centres, called the Type 1 diabetes Immunotherapy Consortium. It has put the building blocks in place to take immunotherapy research in Type 1 diabetes up a gear, allowing scientists to run clinical trials and gain insights into how potential treatments work.
We set up this bold initiative with JDRF in 2015, when we committed £2.8 million in partnership with Tesco. The Consortium’s ambition is to make the first immunotherapy for Type 1 diabetes available. This would represent a major shift in the way we combat Type 1 diabetes, moving us towards treating its cause – an immune system attack.
Meet Dr Tim Tree, a scientist who co-leads the Consortium, and meet Ruby, who has Type 1 diabetes and took part in an immunotherapy clinical trial.
Most trials involve people newly diagnosed with Type 1 diabetes – who still have some working beta cells in their pancreas – so scientists can test if an immunotherapy is able to protect these cells from further damage. This means there is a 100-day window after diagnosis when someone can take part in a trial.
Previously, only around 30 of every 3,000 eligible people diagnosed with Type 1 diabetes each year took part in an immunotherapy trial. To put this in perspective, one early-stage clinical trial to test the safety of a new drug could require all 30 of those people, and each later trial would then need more and more people to take part. The lack of participation was holding back progress and the Consortium wanted to change this.
Alongside the ADDRESS-2 platform, they’ve been supporting recruitment to trials, so that more children and adults diagnosed with Type 1 diabetes have the chance to take part. So far, they’ve increased recruitment five-fold and have helped the UK go from struggling to carry out immunotherapy trials, to now being one of the top recruiters in Europe.
Professor Colin Dayan, Immunotherapy Consortium scientist said:
"We’ve changed the landscape in the UK into one where we can run many more trials and recruit to them quickly. We couldn’t do this before. And I think this is going to open the flood gates to finding more drugs that work, and we’ll really see things take-off”
Creating centres of excellence
The Consortium has created a network of research centres and teams, led by Professor Colin Dayan. They provide the expertise and infrastructure needed to run large immunotherapy clinical trials. The network has already completed three ground-breaking trials and they’re now running nine more.
The rare mix of clinical trial sites and immunotherapy experts has acted as a springboard and helped the Consortium to secure millions in extra funding for immunotherapy research from other sources. Investment and commitment from the wider diabetes research community is essential to speed up progress.
The Consortium’s lead scientists are also training up the next generation of experts, to make sure immunotherapy research can go from strength to strength, treatments can get better and more lives can be changed.
Unravelling how treatments work
The Consortium’s research sites ensure that their trials are carried out in a similar, harmonised way. This allows for a unique opportunity to combine results. Each individual study gives scientists important insights but when we can analyse multiple trials together, it becomes far more powerful.
Dr Tim Tree, Immunotherapy Consortium scientist said:
"If we do science in isolation, without pooling all of our data in a collaborative way, you can understand a bit of the picture but not the whole thing. What we’re doing in the Consortium is trying to compare results between trials and measure all parts of the immune system, in all people. That’s how we can really understand how and why therapies work”
Dr Tree has set up world-leading specialist labs where blood samples from different trials are analysed to investigate exactly how treatments work to control the immune system attack.
And because not everyone with Type 1 diabetes is the same, they’re unpicking why particular treatments benefit some people and not others, to see if it’s possible to figure out which therapy should be given to who. This has allowed Dr Tree to uncover specific changes within the immune system in people who retained more beta cells after treatment, than those whose cells were destroyed more quickly.
The Consortium’s scientists have also figured out the best dose of drugs to have the desired impact on the immune system, helping to smooth the path to larger trials and ensure that they are more likely to succeed.
What we hope to achieve
The Consortium’s work is moving us closer to the biggest shift in Type 1 diabetes treatment in 100 years. Their scientists are changing the research landscape to help ensure new treatments that could slow Type 1 diabetes reach people newly diagnosed faster.
With continued research and more breakthroughs, down the line immunotherapies could also be given to prevent Type 1 diabetes or could form part of a cure for people living with the condition today. Read more about immunotherapy and its potential to change lives.