Immunology of Diabetes Society: the take-away of May 24th, 2023.

In the United States and as far away as Europe, the verapamil rumor is starting to gain momentum. This molecule, which is already listed and available in all pharmacies, seems to have a certain propensity to delay the diagnosis of T1D, in addition to its ability to treat hypertension for the past 40 years.

As with all rumours, a certain amount of restraint should be exercised until the results of the Innodia trial are available in a few months. We will then see if the rumour is true and if the European study confirms all the good things that are said in the US. 

By inhibiting the TXNIP gene, present on the islets of Langerhans, verapamil produces a series of beneficial effects in terms of insulin production and, in particular, the end of inflammatory stress around the beta cells. This preservation of cells is accompanied by a series of encouraging indicators. The drug taken orally daily for one year showed its ability to reduce the need for exogenous insulin while maintaining good glycemic control. Without causing any hypotension, for which it is normally prescribed, Verapamil behaves like a modulator of autoimmune attacks, without having the profile and actions. The presence of peptide-C, a sign of a pancreatic response to glucose, partially persists, as do the other improvements observed, for at least two years with continued use of the pills. 

The only point that seems to moderate the bright future of this reoriented molecule is its limiting effect on glucagon production in the face of stress and hypoglycemia. However, a new molecule, TIX100, seems to offer the same guarantees as Verapamil by ensuring glucagon secretion and eliminating the risk of severe hypoglycemia.

In either case, your back is assured: a bodyguard available as close to the pancreas as possible.

The work of Australian immunologist Leonard Harrison on the microbiome ("the set of microorganisms that live on our body, our skin and inside our body on our mucous membranes") of pregnant women living with T1D invites us to look at pregnancy in a new way. Men with T1D are more likely to pass on their disease to their child than women with T1D. And Harrison's work confirms this postulate based on the concept of "maternal protection". Speaking to Glucose toujours, he explains: "The mother's microbiome has an impact on the child's immune system before birth”. In fact, mothers with T1D develop an inflammation of the microbiome that would protect the child. "We believe that mothers form their children's immune system through their microbiome [editor’s note: the mother's] during pregnancy. When the child is born, it has a strong immune system and is able to tolerate infections better and regulate itself better, so the risk of diabetes is lower." 

The immunologist adds that there is another mechanism: "the mother with T1D produces more protective immune cells, the regulatory B cells, which are found in the blood of the umbilical cord of the newborn and we postulate that they protect the child against T1D". For women who are afraid of passing on their T1D to their child, Harrison is reassuring: "During pregnancy, the risk is much higher for the woman to suffer complications if she has T1D than to give birth to a baby who will have T1D." Kevin Costner's arms remain more consoling.

T1D is characterized by an uncontrolled T-cell reaction against beta cells, while at the same time protecting the body from multiple aggressions. But there is always time to put things in order before they get out of hand.

To protect what can still be protected, the professor of microbiology and immunology Pere Santamaria, presented today the principles of action of the drug Navacims. This is a relevant option for the autoimmunity around pancreatic cells, when control of the situation can still be regained, prior to diagnosis.

It works in two ways: the molecule allows the destructive T cells to multiply and be transformed into regulatory cells of the immune system, thus calming the tensions surrounding insulin production. Through this intervention, a new tolerance is established by reversing the ambient disorder through immunology. The good news is that protection is achieved without any downside. The immune system is not affected and continues to play its standard protective role. 

Maximum protection and seamless service is what Navacim's nanoparticles seem to promise us, by preventing too much conflict in the land of blood sugar regulation.

Belgian diabetologist Chantal Mathieu explains in a video (VOSTFR) why people should be screened :