‘Inverse Vaccine’ for Type 1 diabetes

An innovative new vaccine for Type 1 diabetes is being developed, which reverses certain immune responses rather than activating the immune system.

“We are trying to educate the immune system to teach it what not to do,” Bart O. Roep, Chan Soon-Shiong Shapiro Distinguished Chair in Diabetes at City of Hope and professor/chair of the Department of Diabetes Immunology said. “It is a radical approach that does not involve immunosuppression – it engages the immune system and causes desensitization, like allergy treatments.”

The vaccine is reported to be safe based on results from a small Phase I trial.

The process begins by taking blood from the patient and isolating certain white blood cells. These are then turned into special immune cells called dendritic cells – key regulators that help train other immune cells to recognise invading pathogens.

The dendritic cells are then grown for six days in liquid containing vitamin D3. As well as being important for calcium regulation and bone health, vitamin D3 also regulates the immune system, causing anti-inflammatory effects.

The anti-inflammatory dendritic cells will encourage other Type 1 diabetes-causing immune cells to ignore insulin-producing beta cells, preventing their destruction. Two days before the cell-based vaccine is given to the patient, the dendritic cells are thawed and treated with a fragment of proinsulin, a precursor protein to insulin. Proinsulin is an autoantigen that provokes the immune system to destroy insulin-producing cells in T1D patients.

These ‘trained’ dendritic cells regulate the patient’s immune system by training T-cells not to attack proinsulin. Once in the patient, the dendritic cells from the vaccine induce regulatory T-cells (Tregs), which regulate other immune cells, such as the ones that attack insulin-producing cells in the pancreas.

The vaccine is administered in two injections by a patch near the pancreas one month apart, as a primer and a boost.



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