A drug commonly used to treat high blood pressure (hypertension) may also help to prevent type 1 diabetes development or progression in up to 60% of people.
While we do not know exactly what causes the immune attack that leads to type 1 diabetes (T1D), we do know that certain genes increase our risk, and the development of T1D is likely a mix of our genes and environmental factors.
Enter a gene variant, known as HLA-DQ8. Genetic variants are differences in the human genome that make each person unique. This variant is associated with a higher risk of developing T1D and is found in up to 60% of people with T1D. Researchers sought to find out if blocking the gene could prevent T1D in the group of people who carry this variant.
The partly JDRF-funded study, led by Dr Aaron Michels at the Barbara Davis Centre for Childhood Diabetes in the USA, used a ‘supercomputer’ program to analyse the structure of all US Government-approved drugs to determine if any could block the gene. A match came back for a drug called methyldopa, which has been used for over 50 years to treat high blood pressure.
To see if methyldopa could prevent T1D, the researchers studied mice before moving onto a small clinical trial in people.
Twenty people who had been diagnosed with T1D within two years took part in the trial. All were still producing small amounts of insulin. The group took three methyldopa tablets a day for six weeks. Researchers found that the drug was able to block HLA-DQ8, which limited the destruction of the beta cells and preserved their function.
Next, the researchers will run a larger and longer clinical trial, to see how effective methyldopa is in a more diverse group of people. The drug could help preserve beta cell function after diagnosis, meaning less artificial insulin is needed. This research may also have the potential to lead to an effective personalised preventative therapy for some people at risk of T1D.
Because the drug is already approved for use in humans, if it proves successful in larger clinical trials, then the regulatory pathway will likely be faster compared to new therapies.
Full results of this study are published in the Journal of Clinical Investigation.
What is happening in the prevention space in Australia?
There is a lot happening in Australia to find ways to prevent T1D so no one in the future has to experience it.
We have researchers looking into different aspects of the immune cells and how they behave, to try and figure out what goes wrong, causing T1D to develop. There are researchers investigating the role of bacteria in our gut when T1D develops so that treatments can be directed there. We have teams investigating the use of biomarkers to detect and predict beta cell loss, and others designing immune therapies to target immune cells.
What can I get involved in?
ENDIA and TrialNet are ongoing prevention initiatives in Australia that are looking for participants.
The ENDIA (Environmental Determinants of Islet Autoimmunity) study is underway in Australia with the aim to find ways to prevent T1D in future generations. You might be eligible if you or your partner is pregnant and the baby will have a first-degree relative with T1D (mum, dad or sibling). If you’d like to find out more about ENDIA, head to their website or call: (08) 8161 8747
TrialNet is an international network of people and institutions dedicated to prevention of type 1 diabetes. People at risk of T1D (have a relative with T1D) may be eligible for screening or prevention studies. Sign up on their website to find out more.
If these are not relevant to you at this stage, sign up to be a T1D Game Changer where you can hear about current and future recruiting trials.