A way has emerged to predict diabetes before the first symptoms appear
Scientists have come up with a new method of diagnosing type I diabetes by analyzing CD4 T-cells through a long-term study in a larger group of participants, comparing the experimental approach to a more traditional one.Scientists at Scripps Research found that analyzing a certain type of immune cells in the blood could help identify people at risk of developing type I diabetes, a life-threatening autoimmune disease.
If further research confirms the new technique for detecting type I diabetes, the autoimmune disease could be prevented, the scientists believe.
Type I diabetes occurs when the immune system destroys insulin-producing islet cells in the pancreas. The autoimmune process requires lifelong insulin replacement.
In 2022, the U.S. Food and Drug Administration approved an immunosuppressive therapy that will protect the islet cells and delay the onset of diabetes by months or years. Treatment should start her in the early stages of the disease. However, doctors didn't know how best to identify patients who would need the therapy.
So far, they've looked at levels of antibodies to islet cells in patients' blood samples, but that's not the most accurate method. "Islet cell antibody levels are poorly predicted at the individual level, and type I diabetes is primarily a T-cell disease," the researchers wrote.
The authors of the new study constructed protein complexes to mimic the mixture of immune proteins and insulin fragments that specialized CD4 T cells normally recognize to initiate an autoimmune response. They used these constructs as bait to capture anti-insulin CD4 T cells in blood samples. The scientists then analyzed the activity of genes in the captured T cells and the expression of proteins on them to measure their activation state. In this way, they developed a classification algorithm that correctly identified which at-risk patients in the set of nine were characterized by persistent autoimmunity against islet cells.
The scientists now hope to validate the CD4 T-cell approach with a long-term study in a larger group of participants, comparing the experimental method with a more traditional one.