Researcher may have a cure for Type 1 diabetes

Ben-Gurion University researcher may have a cure for Type 1 diabetes

Click photo to download. Caption: Dr. Eli Lewis (pictured), a world-renowned expert on autoimmune disease and the director of the Clinical Islet Laboratory of the Department of Clinical Biochemistry & Pharmacology at Ben-Gurion University, may have a cure for Type 1 diabetes. Credit: Danny Machlis, Ben-Gurion University.

By Maayan Jaffe/JNS.org
While methods of insulin administration have improved, and modes of measuring how much insulin to give are far superior to those of the 1920s, when insulin was discovered, there have been no major advancements toward a cure for Type 1 diabetes for almost a century.
Until now, Dr. Eli Lewis believes.
“Tissue damage actually plays a role in Type 1 diabetes… but it is often overlooked and under-studied,” Lewis—a world-renowned expert on autoimmune disease and the director of the Clinical Islet Laboratory of the Department of Clinical Biochemistry & Pharmacology at Ben-Gurion University (BGU)—told JNS.org. “There was at least one stone that was left unturned.”
In 2003, Lewis began his research into the role of inflammation in injured islets, tiny clusters of insulin-producing cells scattered throughout the pancreas. And during that time he discovered that Alpha 1 Antitrypsin (AAT), an anti-inflammatory drug based on a natural protein our bodies produce each day and generally used to treat emphysema, not only shows promise for reducing insulin dependence but in some cases can actually cure a person of Type 1 diabetes.
Type 1 diabetes plagues 25.8 million Americans of all ages, about 8.3 percent of the U.S. population, according to the National Diabetes Information Clearinghouse. A similar percentage of the Israeli population is affected, said Lewis, who added that on average 40 more Americans are diagnosed with Type 1 diabetes each day. All Type 1 diabetics require insulin treatment.

Click photo to download. Caption: Insulin vials. While methods of insulin administration have improved and modes of measuring how much insulin to give are far superior than they were in the 1920s, when insulin was discovered, there have been no major advancements toward a cure for Type 1 diabetes for almost a century. But Dr. Eli Lewis of Ben-Gurion University may change that. Credit: Mr Hyde via Wikimedia Commons.

The hormone insulin, produced by clusters of cells found on islets that reside in the pancreas, enables the body to remove glucose (sugar) from the blood into storage locations such as liver and muscle. These cells are the targets of an autoimmune response in Type 1 diabetes. When the cells become inflamed and ultimately malfunction, insulin can no longer be produced. In a healthy individual, the body naturally produces systemic AAT in the liver that helps repair tissue and reduces inflammation. It was recently established that AAT, although present in patients with Type 1 diabetes, does not function in its glycated form.
In three recent clinical trials that took place at BGU, the Barbara Davis Center for Childhood Diabetes at the University of Colorado School of Medicine, and the Joslin Diabetes Center (affiliated with Harvard Medical School), recently diagnosed patients received injections of functioning AAT in the form of a liquid slow-drip infusion. They basically regained the ability to fight inflammation and protect damaged cells from aberrant immune responses. Within eight to 12 weeks AAT therapy was withdrawn, and in several patients proper glucose levels were controlled without the need for insulin injections for more than two years.

Click photo to download. Caption: Pictured in center is Dr. Eli Lewis, a world-renowned expert on autoimmune disease and the director of the Clinical Islet Laboratory of the Department of Clinical Biochemistry & Pharmacology at Ben-Gurion University. Lewis may have a cure for Type 1 diabetes. Credit: Danny Machlis, Ben-Gurion University.

Since AAT was already approved by the Food and Drug Administration (FDA), it received fast-track approval into human clinical trials in the U.S., Lewis said, noting it still will take at least another two years for AAT to receive FDA approval as an on-label treatment for Type 1 diabetes. But some physicians have been prescribing it in the meantime as an off-label treatment.

Dana Heffernan’s son Zach, 11, received AAT treatment from his doctor in San Antonio, Texas. Heffernan said her son was diagnosed on Nov. 12, 2013 and received his first treatment in mid-December.

“He went from approximately 10 units of insulin per day [70 units per week] down to two units per week. So that is pretty significant. Will he ever be off insulin completely? That is my hope, but we will have to see,” Heffernan said.

In another public case, which Lewis discussed, the Consul General of Israel to the Pacific Northwest, Andy David, accessed AAT for use in treating his 9-year-old daughter. She underwent once-a-week slow-drip infusions of AAT for 8 weeks. That was close to three years ago, and she has not had to have insulin since.

The treatment, however, may not be effective for all patients. Dr. Peter A. Gottlieb, professor of pediatrics and medicine at the Davis Center, led the Colorado clinical trial. He said the treatment was promising for about one-third of those who received AAT, but was less effective or even ineffective in others. He attributes this to multiple factors, including how long the person has had the disease and how much of the AAT was administered. He said another set of clinical trials is underway using larger doses. Lewis said in all trials, if one has been diagnosed with Type 1 for more than six months “the benefits are minimal.”

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