Challenging Traditional Views on Diabetes

Conventional approaches for treatment of Type 1, or juvenile-onset diabetes, may be incorrect, a group of Medical School researchers reported last month, suggesting that scientists should use different strategies in their current search for a vaccine.

Scientists have traditionally thought that the immune attack which characterizes juvenile-onset diabetes occurs as a result of immune cells recognizing and binding to specific response on pancreas cells.

But Instructor in Medicine Dr. Myra A. Lipes, who works at the Joslin Diabetes Center, challenged traditional thinking last month when she reported in Science that the specificity of such cells may play no role in diabetes. She found that mice genetically prone to diabetes still developed the disease even when such cells were programmed to recognize cells not in the pancreas.

Type I diabetes occurs when a body's T-cells, which coordinate the immune response, mistakenly initiate an immune attack on the body's own pancreas cells.

Lipes said in telephone interview yesterday that the finding argued for "a reappraisal of the role of T-cell receptors in disease pathogenesis."

Diabetes, along with multiple sclerosis and rheumatoid arthritis, is an autoimmune disease, in which the body's immune system attacks the body's own cells. "This changes the way one thinks about autoimmunity," said Lipes.

"When you look at multiple sclerosis, there's a big body of information saying that specific alpha beta receptors may play role in that disease," said Lipes. "That's probably not the case in diabetes."

The finding will probably shift the focus of the search for a diabetes cure from vaccines aimed at specific T-cell receptors to research on other immune cells, the article said.