An immunotherapy that stimulates tumor necrosis factor (TNF) may hold promise as a therapy for type 1 diabetes, researchers found.
In a small, proof-of-concept study, treatment with a Bacillus Calmette-Guerin (BCG) vaccine killed off disease-causing autoimmune cells and improved insulin sensitivity as measured by C-peptide levels, Denise Faustman, MD, PhD, of Harvard, and colleagues reported online in PLoS One.
The findings suggest that "BCG or other stimulators of host innate immunity may have value in the treatment of long-term diabetes," they wrote.
BCG, a generic vaccine, stimulates innate immunity by inducing the production of TNF, which kills the autoimmune T lymphocytes that destroy insulin-secreting pancreatic beta cells -- those that cause type 1 diabetes -- while leaving healthy T cells unharmed.
TNF at high doses, however, causes systemic toxicity. So instead the researchers sought an alternative approach with an FDA-approved vaccine that can induce TNF by triggering the innate immune response.
They conducted a proof-of-concept study in patients with longstanding type 1 diabetes; mean age was 35.
Six patients received injections of either the BCG vaccine or a placebo and were compared with their baseline statistics, healthy controls, and 57 reference patients with type 1 diabetes and 16 reference patients who didn't have the disease.Further