A recent study from Sweden found that nearly half of patients with type 1 diabetes, even after 10 years, may still produce insulin.1 Type 1 diabetes is an autoimmune condition in which the beta islet cells which produce insulin are targeted and destroyed by the immune system. It has long been an accepted medical fact that individuals with type 1 diabetes completely lose their ability to produce insulin. Not only does this research question the pathophysiology of an extremely common and well researched autoimmune disease, but also poses possible directions of treatments to perhaps reverse the disease.
Uppsala University Study
The study was conducted at the Uppsala University in Sweden, and looked at 113 patients with type 1 diabetes. All participants included in the study had been diagnosed with type 1 diabetes for more than 10 years. Beta islet cell function was assessed using an ultra-sensitive C-peptide ELISA. Circulating cytokines, with specific attention to interleukin-35 (IL-35) were also assessed – IL-35 is a known anti inflammatory cytokine.
C-peptide Levels Indicative of Insulin Production
Roughly half of the participants were found to have C-peptide levels indicative of insulin production. In blood samples which were C-peptide positive, IL-35 levels were also seen to be higher, as well as other immune cells which dampen immuno-activity. In previous research, it has been shown that IL-35 helps maintain the phenotype of Treg cells and change the differentiation of T-helper 17 cells thereby lowering the activity against beta cells in the pancreas.2 There was a decrease in IL-35+ regulatory T cells (Tregs), IL-35+ regulatory B cells, and IL-35-producing CD8+Foxp3+ cells in the C-peptide negative blood; all cell types associated with an increase assault on beta islet cells. IL-17a+ cells among the Tregs, CD4+ T cells, and CD8+ T cells were all lower in the C-peptide-positive participants.
Questions of the exact meaning of the higher levels of IL-35 are still being asked, however, IL-35 levels have been observed in other research to be lower in diabetic type 1 patients than healthy controls.2 IL-35 has also been utilized in murine models to reverse type 1 diabetes,2 which is the ultimate goal of this current research.
Sources
- Espes D et al., Increased Interleukin-35 Levels in Patients With Type 1 Diabetes With Remaining C-Peptide, Diabetes Care 2017 Jun.
- Singh K, Kadesjö E, Lindroos J, et al. Interleukin-35 administration counteracts established murine type 1 diabetes–possible involvement of regulatory T cells. Sci Rep. 2015;5:12633.
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Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp out where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.
