Subpopulation of Beta Cells Found to Survive in Type 1 Diabetes

The authors of a new study discovered how some insulin-producing pancreatic cells survive in patients with type 1 diabetes, even when most are destroyed by the immune system. This finding may create novel strategies aimed at recovering these cells in patients with diabetes.

Beta cells, which produce insulin in the pancreas, are typically destroyed in patients with type 1 diabetes, but some survive for years after disease onset.

Type 1 diabetes is an autoimmune disorder that is typically diagnosed during adolescence, but patients can be diagnosed as infants, which is why it is also known as juvenile diabetes. Patients with type 1 diabetes currently have to undergo lifelong insulin therapy, in addition to healthy diet and exercise habits.

Recently, a team of researchers analyzed changes in beta cells to determine why certain cells survive an immune system attack, in a study published by Cell Metabolism. Specifically, the authors examined changes in the cells that take place during immune response, which leads to survival in mice and cell lines.

The investigators discovered that there is a subpopulation of beta cells that are resistant to immune system attack in type 1 diabetes.

"During the development of diabetes, there are changes in beta cells so you end up with two populations of beta cells," said senior study author Kevan Herold, MD. "One population is killed by the immune response. The other population seems to acquire features that render it less susceptible to killing."

The subpopulation of beta cells are able to evade an immune system attack by hiding from immune cells. These beta cells express molecules that allow it to inhibit the attack, and also acquire a stem cell-like ability to revert to earlier forms of the cell, according to the study.

When the beta cells revert to an earlier stage of development, they are able to survive and proliferate, despite the immune system response. These cells can survive for years after initial attack.

These findings will likely lead to new studies that explore strategies to benefit patients with type 1 diabetes, according to the study.

"The next question is, can we recover these cells so that there is insulin production in someone in type 1 diabetes?" Dr Herold said.

The authors are planning to conduct further studies to determine whether certain drugs are able to alter the subpopulation of beta cells, and turn them into insulin-producing cells. This could essentially cure a patient with type 1 diabetes, since they will be able to create their own insulin, and will no longer rely on injected insulin.