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Tuberculosis vaccine offers new hope for treating Type 1 Diabetes

September 4, 2012 in News

Bacille Calmette-Guerin (BCG) is a mouthful, but it has been used successfully to combat tuberculosis for the past 90 years. These days, it is also used as a treatment for bladder cancer. Now, a small study has provided preliminary evidence that this vaccine could help fight type 1 diabetes as well.

The vaccine increases levels of a substance naturally produced in the body, tumor necrosis factor (TNF). High levels of TNF are toxic, but BCG does not seem to raise levels of TNF high enough for this to happen.

In type 1 diabetes, some of the body’s own T-cells become autoreactive – instead of attacking infectious agents like bacteria, they turn on the body’s own cells. In the case of type 1 diabetes, the rogue T-cells attack the insulin-producing beta cells in the pancreas.

The researchers found that increasing levels of TNF by using two rounds of the BCG vaccine caused many of the rogue T-cells to die.

The study was very small; only six people participated, and three were given a placebo instead of the BCG treatment. Over the twenty weeks the patients were followed, two of the three treated with BCG showed evidence of rogue T-cell death. In addition, their levels of healthy T-cells increased.

The most promising result of the trial was that in all three of the participants who received BCG, levels of a compound called C-peptide increased. C-peptide indicates that insulin production is taking place.

While C-peptide levels did increase in all three patients, their need for insulin did not change. However, the fact that any insulin production occurred in three individuals who had lived with type 1 diabetes for an average of fifteen years implies that even after years of living with the condition, the pancreas can “kick on” again with the right treatment.

There are still a lot of questions for the researchers to answer, most importantly how the BCG vaccine will affect children. The trial was conducted in adults only; it is important for a treatment for type 1 diabetes to be safe for children.

Other questions include how patients respond over a longer period than 20 weeks, and what the long-term effects of the treatment will be. Researchers also do not yet know how many treatments would be needed, or how often they would need to be repeated.

Still, these findings are very promising. BCG has an excellent safety record, and has been administered to billions of adults and children across the globe to prevent tuberculosis. The findings also provide important information about the ability of the pancreas to begin functioning again once the attacks from rogue T-cells are halted.

Even if the treatment is only able to increase a little C-peptide over the long term, any restoration at all of C-peptide can help prevent the complications of type 1 diabetes.

The next step for researchers is a phase II trial, which will involve a larger group of participants.

You can read more about the study results in a news release on HealthDay.com.



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