New JDRF-funded research has uncovered why some people may be more resistant to developing type 1 diabetes, despite blood tests showing that they are at risk.
The research found that these people share some similarities in their immune systems with people who do not have type 1 diabetes.
They may even have some protective adaptations to their immune systems.
The findings improve our understanding of the underlying causes of type 1 diabetes – and could help future efforts to prevent or cure the condition.
Studying slow progressors
Writing in the journal Diabetologia, the research team (including JDRF researchers Professor Kathleen Gillespie, Professor Colin Dayan and Dr Anna Long), explained how they found these protective characteristics by focusing on people who have two or more autoantibodies in their blood.
In type 1 diabetes, autoantibodies are a sign that the immune system is targeting the insulin-producing beta cells of the pancreas.
Most people with at least two autoantibodies are eventually diagnosed with type 1 diabetes.
Yet up to 30% of people who have two autoantibodies do not go on to develop the condition within 10 years.
This suggests that these ‘slow progressors’ have something in their immune systems that helps delay the onset of type 1.
Immune system differences
By analysing blood tests from the long-running Bart’s Oxford Family Study, the researchers found slow progressors lacked one of the key immune cells that kills insulin-producing beta cells.
In addition, most of the slow progressors showed lower levels of the autoantibodies in their blood over time. Some no longer tested positive for two autoantibodies in later blood tests.
These changes make them more like people who do not have type 1 diabetes.
The research team also found one more potential protective factor that set the slow progressors apart. Even though some of their immune cells were primed to target insulin-producing cells, these immune cells also seemed to be more susceptible to self-destructing.
The researchers suggest that this could be one way that these participants’ immune systems keep themselves in check.
Steps towards prevention and cure
Conor McKeever, Research Communications Manager at JDRF, said: “One of the core questions at the heart of our research is why some people develop type 1 diabetes, while others do not.
“These findings bring us another step closer to understanding why some people seem to be protected against developing type 1.
“This information could lead us to new ways to modify the immune system, potentially enabling us to cure or prevent type 1 diabetes.”
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