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Re: [IPp] Is BCG a cure for diabetes? The long road to acceptance

Sorry I took so long to respond.  Amazing how time passes when you aren't

I think this research is absolutely fascinating and very hopeful.  Dr.
Faustmann is a paradigm-buster, and I love that.  I'm also thrilled that
they are gearing up for Phase 2 trials.  On the other hand, I haven't told
Brian (my son) about this work yet because there are a LOT of questions to
address in the trials.  So often things that look promising in mice (or rats
or flatworms or whatever) don't turn out to translate to the human body.
But I am definitely keeping an eye on her work and have my metaphorical
fingers crossed....

Chris Brostrup-Jensen

On Mon, Jun 27, 2011 at 2:42 AM, Rachel A <email @ redacted> wrote:

> Thoughts?
> Is BCG a cure for diabetes? The long road to acceptance
>  - [image:
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>   4
> [image: Dr. Denise Faustman and her colleagues hope eventually to cure
> diabetes.]
> Dr. Denise Faustman (center) and her colleagues hope eventually to cure
> diabetes. (Graham Ramsay/Harvard Medical School)
> By Thomas H. Maugh II, Los Angeles Times/For the Booster Shots blog
> June 25, 2011, 11:54 a.m.
> The first trial in a handful of humans has suggested that injecting
> patients
>  with Type 1
> diabetes<
> >
> with
>  an inexpensive
> vaccine<http://www.latimes.com/topic/health/vaccines-HEDAR00000154.topic>
> normally
>  used to
> preventtuberculosis<
> >
>  can block destruction of
> <http://www.latimes.com/health/la-he-bcg-diabetes-20110625,0,6341862.story
> >
> insulin<
> http://www.latimes.com/topic/health/human-body/insulin-HHA0000095.topic
> >-secreting
> pancreatic cells in humans and allow regeneration of
> thepancreas<
> http://www.latimes.com/topic/health/human-body/pancreas-HHA0000092.topic>.
> Such a finding, if confirmed and expanded on, could lay the foundation for
> freeing the estimated 1 million U.S. Type 1 diabetics from their daily
> insulin
> shots<
> >.
> It brings up a word that is rarely or never used in considering the
> disease:
> "cure." Such an outcome is still a long way in the future, but Dr. Denise
> Faustman ofMassachusetts General
> Hospital<
> >
> has
> already come a long way in her quest to find a new treatment paradigm for
> diabetes.
> Researchers have always assumed that insulin-secreting cells could never be
> regenerated. Once they are gone, they are gone forever, the theory held.
> Scientists have thus focused on ways to prevent their loss -- such as by
> developing vaccines that will halt the immune
> system<
> http://www.latimes.com/topic/health/human-body/immune-system-HHA000031.topic
> >'s
> attack on the pancreas before all the cells are destroyed -- or by
> transplanting replacement cells from a donor. The first approach has not
> yet
> shown much success, and the second has provided only limited benefits.
> Insulin-secreting cells for transplants are difficult to obtain in
> quantity,
> provoke a strong immune response and require immunosuppressive drugs. They
> can "cure" diabetes, freeing patients from their insulin secretions, but
> the
> benefits often disappear with time.
>   -
> Faustman started out as a transplanter, learning her technique from Dr.
> Paul
> Lacey of Washington University of St. Louis, a pioneer in the field. When
> she came to Mass General in 1985, she was confident that she could do the
> transplants better than other researchers and that her attempts would
> succeed. For one of the few times in her life, however, it turned out that
> she was wrong.
> She decided to go back into the lab and attempt to figure out why the
> transplants were failing. Most researchers had studied transplants in mice
> in which the pancreas was artificially destroyed. Faustman decided to look
> at mice that, like humans, had a strong propensity to develop diabetes
> naturally. She found that the transplants failed in those animals just like
> they had in her human trials, and she eventually determined that the
> rodents' immune systems were attacking the transplanted cells just like
> they
> had their own pancreases.
> Eventually, she developed a two-pronged attack. First she injected the mice
> with Freund's Complete Adjuvant, a mixture of water, oil and parts of dead
> bacteria that is sometimes used to increase the power of vaccines. The
> adjuvant overstimulated the immune cells that were attacking the pancreas,
> causing them to self-destruct. She also injected the rodents with BCG,
> known
> formally as bacillus Calmette-Guerin, which has been used for 80 years as a
> preventive for tuberculosis. It stimulated the production of another immune
> component, called tumor necrosis factor or TNF, that kills the cells that
> were attacking the pancreas.
> Faustman's goal was simply to prevent the attack on islet cells of the
> pancreas so that a new transplant could have a chance to take hold. To her
> great surprise, however, the treated mice began producing insulin again --
> a
> finding that contradicted everything researchers believed about diabetes.
> Eventually, however, other labs were able to replicate her results.
> In subsequent papers, Faustman showed that the new insulin-secreting cells
> were being produced by the spleen, a fist-sized organ that plays a crucial
> role in recycling
> blood<http://www.latimes.com/topic/health/human-body/blood-HHA00006.topic>
> cells.
> First, she demonstrated that the cure of the mice could be accelerated by
> injecting extra spleen cells into the animals. Then she transplanted male
> spleens into female mice undergoing the treatment and demonstrated that the
> insulin-producing cells were male in origin.
> Very little research has been conducted in humans about what happens to
> patients after their spleens have been removed for medical reasons. But
> Faustman found two studies, one of British patients with pancreatitis and
> one of children with beta-thalassemia, in which their spleens had been
> removed. In both groups, many of the patients developed diabetes within
> five
> years after their surgery. These findings suggest that the spleen plays a
> key role in regulating glucose uptake.
> Faustman had great difficulty obtaining research funds because her ideas
> were so contrary to the prevailing wisdom. One person who believed in her,
> however, was Lee A. Iacocca, the former chief of Chrysler Corp., whose wife
> Mary died of diabetes. Iacocca wrote her a check for $1 million and by
> 2006,
> his Iacocca Family Foundation had raised more than $11 million for her
> research.
> She is now gearing up for a larger, phase 2 clinical trial of the
> technique.
> More information about her research can be obtained
> here<http://www.faustmanlab.org/> and
> those interested in participating in the trials can e-mail her at
> email @ redacted But be warned there is already a long waiting
> list.
> Rachel - email @ redacted
> http://www.google.com/profiles/rachelandcole<
> http://www.google.com/profiles/rachelandcole#>
> https://www.facebook.com/AllBrightPhotography
> .
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