\u201cThis, right now is very promising,\u201d Steinman says following a clinical trial where 80 people were treated for 12 weeks then followed for an additional year with his \u00a0\u201creverse vaccine\u201d procedure. \u201cWe not only saw better production from [insulin producing] beta cells, but we also saw significant improvement regarding managing the immune response so that the beta cells remained active and alive.\u201d<\/p>\n
Steinman\u2019s treatment is two-step process. The first step involves using a plasmid, which is a circular strand of artificial DNA, as a drug to encode \u201cpro-insulin,\u201d which is a nonfunctioning precursor to insulin. The plasmid makes its way into muscle cells, which in turn begin to produce pro-insulin. Unlike beta cells, however, muscle cells are unable to convert pro-insulin into functional insulin peptides.<\/p>\n
This action is similar to many other attempts to cure type 1 diabetes that replace insulin-producing beta cells. Many of these attempts have stalled, however, not because the beta cells are faulty, but because the body\u2019s immune system aggressively attacks and eliminates the newly introduced cells producing the insulin.<\/p>\n
So why bother making non-functional insulin? This is what makes the drug truly exciting.<\/p>\n
When the muscle cells begin producing pro-insulin, the cells of the immune system are tricked into thinking pro-insulin is a normal protein, not a foreign invader. This process, called \u201ctolerization,\u201d ideally results in immune cells learning that insulin is a good, \u201cself\u201d protein, even when encountered around beta cells. Thus, the DNA plasmid encoding pro-insulin in muscle cells helps to shut off the body\u2019s specific immune response and the invasion of the new beta cells. The body\u2019s immune system is thwarted in its attack of the beta cells, and beta cells are left intact and healthy to produce insulin.<\/p>\n
This rigorous immunosuppression regime for islet cell transplant subjects, however, has been found to actually harm the very delicate islet cells. Instead of using this shotgun approach that suppresses wide swaths of the immune system, the \u201creverse vaccine\u201d takes a rifle shot to suppress only the specific immune response that affects the beta cells.<\/p>\n \u201cIt\u2019s similar to allergies,\u201d Steinman says. \u201cThere are millions of people who go to the allergist and they are tested to see what their specific allergy is so they can be treated appropriately. You don\u2019t, for instance, want to take broad-based cyclosporine [an immunosuppressant] for a peanut allergy.\u201d<\/p>\n The \u201creverse\u201d in the \u201creverse vaccine\u201d means that the DNA plasmid drug is shutting off a targeted immune response to keep cells alive. Other vaccines, such as the flu vaccine, seek to boost the immune response to, in this case, influenza, thereby eliminating it.<\/p>\n Whether the \u201creverse vaccine\u201d will ultimately result in a cure is unknown at this time, Steinman says. But, results from the clinical trial already indicate benefits for helping type 1 diabetics better control their condition.<\/p>\n Because insulin levels are notoriously difficult to accurately measure and track in blood, the trial for the \u201creverse vaccine\u201d instead tracked subjects\u2019 C-peptide levels. C-peptides are an indicator of insulin production, and, according to some studies, may play a role in mitigating diabetic complications, such as blindness and kidney disease.<\/p>\n Commenting on the study in the June 2013 issue of Inside Stanford Medicine<\/a>, Richard Insel, MD<\/a>, chief scientific officer of the JDRF<\/a>\u2014also known as the Juvenile Diabetes Research Foundation\u2014said, \u201cIndividuals with preserved C-peptide are at lower risk of long-term eye, kidney and nerve complications. So it\u2019s intriguing that in this [Steinman\u2019s] study, C-peptide levels were preserved or, at times, increased while patients were receiving the vaccine.\u201d<\/p>\n Even minimal maintenance of insulin production, indicated by C-peptide levels, could be very beneficial over the long term in preventing the complications of type 1 diabetes. \u201cTo be realistic, someone\u2019s going to cure type 1 diabetes,\u201d Steinman says. \u201cBut, in the meantime, if we can reduce complications then we\u2019re doing some good.\u201d<\/p>\n Steinman adds that so far the safety signals from the trial are good, meaning there are no serious side effects.<\/p>\n The next step in the process, he says, is to conduct a more expansive clinical trial on more subjects over a longer period of time\u2013 an effort for which he and other researchers are seeking funding.<\/p>\n Meanwhile, Dr. Lawrence Steinman and his colleagues are not the only ones working on perfecting a \u201creverse vaccine.\u201d<\/p>\n \u201cIt\u2019s a global effort,\u201d he says. \u201cThere is very good work going on around the world in this area, and we\u2019re getting closer.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" Sometimes, when you\u2019re stuck and spinning your wheels without making much forward progress, putting it in reverse can get you going. That\u2019s what Dr. Lawrence Steinman and his colleagues are doing by attempting to cure type 1 diabetes with a unique and groundbreaking \u201creverse vaccine.\u201d<\/p>\n","protected":false},"author":4,"featured_media":35704,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1446,1445],"tags":[535],"yoast_head":"\n![\"Dr.](\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/04\/Lawrence-Steinman-300x275.jpg\" "\\"Lawrence")
<\/a>This method differs sharply from using immunosuppressant drugs to combat the body\u2019s immune response to what it sees as an invader that may cause harm. In islet cell transplantation, for instance, insulin-producing islet cells from a cadaver are transplanted into a type 1 diabetic\u2019s liver to make insulin in much the same way the islet cells in the pancreas once did. Rather than having the specific immune response shut off so that the islet cells may survive, recipients of such transplants take broad range immunosuppressants to keep the body\u2019s immune system from attacking the new cells, much like recipients of full-blown organ transplants.<\/p>\n