Innovative treatment prevents development of diabetes

Key points:

• Researchers from the Babraham Institute have been able to prevent the development of diabetes in mice.
• Their study prevented the death of insulin-producing beta cells in the pancreas, blocking the development of diabetes
• The treatment used a modified virus to manipulate a key molecular pathway in pancreatic cells, which controls the decision of stressed cells on whether to live or die.
• The team hope that their findings will translate into clinical treatment for both types of diabetes.

Researchers from the Liston lab have recently published a preventative therapeutic for diabetes in mice. Their team have been able to prevent diabetes in mice by manipulating signalling pathways in pancreatic cells and preventing stress-induced cell death. The treatment targets a pathway common to both major types of diabetes and therefore could have huge therapeutic potential once translated into a clinical treatment. 

For over 35 years there have been failed attempts to prevent type 1 diabetes development. Previous approaches have sought to target the autoimmune nature of the disease, but Dr Adrian Liston, senior Group Leader in the Immunology research programme, wanted to investigate if there was more causing the deterioration in later stages than just the immune response.

The Liston lab sought to understand the role of cell death in the development of diabetes and therefore approached this problem by identifying the pathways that decide whether stressed insulin-producing cells of the pancreas live or die, and therefore determine the development of disease.

Their hope was to find a way to stop this stress-related death, preventing the decline into diabetes without the need to focus solely on the immune system. First, the researchers had to know which pathways would influence the decision of life or death for the beta cell. In previous research, they were able to identify Manf as a protective protein against stress induced cell death, and Glis3 which sets the level of Manf in the cells. While type 1 and 2 diabetes in patients usually have different causes and different genetics, the GLIS3-MANF pathway is a common feature for both conditions and therefore an attractive target for treatments.

In order to manipulate the Manf pathway, the researchers developed a gene delivery system based on a modified virus known as an AAV gene delivery system. The AAV targets beta cells, and allows these cells to make more of the pro-survival protein Manf, tipping the life-or-death decision in favour of continued survival. To test their treatment, the researchers treated mice susceptible to spontaneous development of autoimmune diabetes. Treating pre-diabetic mice resulted in a lower rate of diabetes development from 58% to 18%. This research in mice is a key first step in the development of treatments for human patients.

 “A key advantage of targeting this particular pathway is the high likelihood that it works in both type 1 and type 2 diabetes”, explains Dr Adrian Liston. “In type 2 diabetes, while the initial problem is insulin-insensitivity in the liver, most of the severe complications arise in patients where the beta cells of the pancreas have been chronically stressed by the need to make more and more insulin. By treating early type 2 diabetes with this approach, or a similar one, we have the potential to block progression to the major adverse events in late-stage type 2 diabetes.”

Doing more with less: Improving flow cytometry staining

Our latest paper isn't going to cure cancer. But it may just making research into curing cancer 10-fold cheaper. A major cost for immunology, oncology and haematology labs is antibodies, especially with the fancy (and expensive!) new dyes coming on the market, which let us hit the 40-50 parameter range in flow cytometry. Fortunately, Dr Oliver Burton in our lab has developed a simple and easy approach to reduce those costs by 10-fold, while also improving the quality of the data: shifting to overnight staining. You can read the full paper here, describing the protocol, fixatives and optimisation approaches, but essentially, lower antibody concentrations give less background, and if left overnight to stain are able to give even better signal detection. It is also a game-changer for wet-lab staff: rather than having all day dissections and staining, and then cueing for flow cytometer hours in the evening, you can set everything up, put on the staining and get an early night. Next morning your cells are ready to go! 

Out now at Current Protocols!

Update on Thursday, November 17, 2022 at 4:54PM by Adrian Liston

We have had multiple requests for a detailed staining protocol, so here it is!

Congratulations to Dr Ana Acosta!

Well done to Dr Ana Acosta, who successfully defended her PhD today! Ana tackled a challenging and exciting project on the role of HNF1A in monogenic diabetes, generating a new mouse model and validating results in primary human islets. Her work dramatically alters the way we see HNF1A in glucose homeostasis and diabetes. A very productive PhD, performed at University of Lille, with Prof Caroline Bonner, and the University of Leuven, with my team. The 20th PhD student to graduate from my lab, and one of the last from our Leuven days! Great job Dr Acosta!

New cause for primary immunodeficiency discovered

Our lab has a new study on primary immunodeficiencies out now at Cellular & Molecular Biology! We studied two families with combined immunodeficiency and found mutations in the Calcium channel ITPR3. The mutations reduce the function of the channel, making the channels 100-fold less capable of initiating a Calcium flux after cellular stimulation. T cells from the patient had poor responses throughout the signalling cascade: reduced Calcium flux, poor nuclear localisation of NFAT1 and reduced proliferative burst, explaining the impeded response to infections. The most severe patient required a bone-marrow transplantation to correct the defect, while the other patient is doing well with regular IgIV treatment. The work established ITPR3 as a new cause of primary immunodeficiency, after previously assuming that these Calcium channels had too much redundancy to be a cause of genetic disease. Read the full paper here, or take a look at the illustrated abstract below for a short-cut summary!

Using gene delivery to protect against diabetes

Exciting new paper out from the lab on using gene delivery to protect against diabetes. The work is based on the "fragile beta cell" hypothesis, which postulates that some individuals are prone to diabetes because their beta cells are more prone to fail during stress situations. We previously demonstrated that the Glis3-Manf axis was central to dictacting how robust or fragile beta cells were, during stresses either immunological (type 1 diabetes) or metabolic (type 2 diabetes) in origin. Based on this data, we designed a gene delivery system, which essentially tricks beta cells into making more Manf and becomes robust in the face of stress. NOD mice, treated with this gene delivery of Manf, become resistant to diabetes. As the gene delivery system we use harnesses the endogenous insulin promoter (specific to beta cells, and upregulated during cellular stress), we can use low doses of the gene delivery system delivered intravenously, without altering the rest of the body. This gives the system a high potential for clinical translation. Read the full paper here, or check out our illustrated abstract below.

An international lab

Scientists have come from 45 countries across 6 continents to work together in our lab!

Lab BBQ

'Eureka moment' as impact of brain injury in mice reduced

Lab picnic

Greater understanding of immune signalling molecule raises hope for improved clinical use

Source of immune signals alters the immune response

Key points:

• Researchers have identified source-specific effects of the signalling molecule interleukin 2 (IL2) on the immune response.
• IL2 is an important signalling molecule that has been harnessed as a biologic therapy for a number of diseases but can result in unwanted side-effects.
• This study, conducted using new mouse models, found that the immune response to IL2 is dependent on the cellular source of the IL2 production.
• Their new insight explains the link between IL2 treatments and side-effects, opening up the potential to apply this powerful immune modulator to optimise treatments while avoiding off-target effects.

A detailed update to our understanding of the key immune system signalling molecule interleukin 2 has been published today by researchers at the Babraham Institute. Their findings explain common side effects of IL2-based therapies, and identify potential new uses of IL2 as an immune-modulating biologic drug. This research was only possible thanks to a new mouse model which allowed researchers to control which immune cell types produced IL2. With further research, this understanding of the rules dictating which cells respond to IL2 could allow scientists to optimise autoimmune and cancer treatment while avoiding unwanted side-effects.

Dr Carly Whyte, lead author on the paper who undertook this research as a postdoctoral researcher in the Liston lab, said: "IL2 is a protein that is normally tightly regulated in the immune system because it has such strong effects. However, when IL2 is given as a therapeutic treatment, these normal restrictions on IL2 are overruled. By using mouse models, we have found that the presence of IL2 in certain zones of the immune system leads to some of the same side-effects that we see in human patients treated with IL2. We hope that by understanding more about how IL2 works in different zones, this treatment might be tailored to be more effective."

IL2 is involved in a large number of different communication networks in the immune system, being produced by a variety of cellular sources and affecting a diversity of cell ‘responders’. It is not only needed for maintaining regulatory T cells, which prevent our body’s immune system from attacking itself, but also CD8 T cells, which attack tumour cells and virus-infected cells. Owing to this dual functionality, IL2 has been harnessed to both promote an immune response, and limit one, depending on the target cells. Despite being actively explored in hundreds of ongoing clinical trials, the full therapeutic potential is currently limited by frequently-encountered side-effects.

Previous explanations for these side-effects were based on the high doses of IL2 when given as a biologic drug, but Prof. Adrian Liston and his team were able to demonstrate that the cell-type making IL2, and the location of those cells, dramatically change the consequences of IL2 exposure. Dr Kailash Singh, co-lead author, explains "Our genetically modified mouse models showed that the immune responses are varied depending on the source of IL2. Our findings revealed that the IL2 response is very much context-dependent, and is not solely due to the concentration of IL2."

Prof. Liston, a senior group leader in the Institute’s Immunology research programme, said: “This work changes the way we think about IL2 as a decades-old therapeutic molecule, demonstrating that it is not just the dose of the IL2 that matters, but also where it is located in the body. Putting together the pieces of this cause and effect intricacy has involved several remarkable scientists and over a decade of research. It was only by bringing together experts in animal research, flow cytometry and immunology, that we had the know-how to tackle the complexity of this question. We’re increasingly aware of the therapeutic power of the immune system, and these findings provide a new avenue of investigation for designing biologic drugs.”

Dr James Dooley, joint senior author of the study, said: "The next generation of biologics will be smarter and tailored to the biology of the disease. This work teaches us that one route of smart design of IL2 is to target delivery to different parts of the body, potentially allowing us to drive very different therapeutic outcomes in patients."

Read the original paper at The Journal of Experimental Medicine!