Harvard Heart Letter

Potential cure for type 1 diabetes

A study conducted at Massachusetts General Hospital has confirmed that a vaccine designed to raise levels of tumor necrosis factor (TNF) temporarily restores insulin secretion in people with type 1 diabetes. The human study followed a 2001 mouse study by the same team of researchers, led by Dr. Denise Faustman, director of the immunobiology laboratory at MGH and an associate professor at Harvard Medical School. That study determined that increasing production of TNF, an immune system modulator, enabled insulin-producing pancreatic islet cells to regenerate.

Because high doses of TNF are toxic, the researchers substituted the bacillus Calmette-Guerin (BCG) vaccine, which elevates TNF levels safely. In type 1 diabetes, the body attacks its own insulin-producing cells and destroys them. By raising levels of TNF, the BCG vaccine kills the destructive autoimmune cells, leaving the islet cells to grow and flourish.

The double-blind human study enrolled six people with a long history of type 1 diabetes and randomly assigned them to receive BCG or placebo. After 20 weeks, two of the three people who received BCG showed blood markers indicating a rise in insulin production and a fall in autoimmune activity.

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