Researchers gain ground in predicting the complication and developing potential therapies

See JDRF-supported researcher Ian DeBoer, M.D., talk about the importance of kidney care and T1D.

Long-term exposure to high blood-sugar levels put a majority of people with type 1 diabetes (T1D) at risk for dangerous complications that affect the function of vital organs. The kidneys are among those organs, and as several abstracts presented at this year’s ADA Scientific Sessions showed, JDRF-supported researchers have been making significant headway in answering questions about how T1D-related kidney disease develops, and what can be done to prevent or reverse it.

In a breakthrough study presented during the Boston, MA conference, JDRF-supported researchers showed that Baricitinib, an arthritis drug, could help reverse T1D-related kidney damage. The drug helps to modulate cell signaling through a system called JAK-STAT, which plays a key role in autoimmune diseases. Supported by JDRF industry research partner Eli Lilly and led by University of Michigan’s Matthias Kretzler, M.D., the research team conducted a phase II international clinical trial that enrolled 129 volunteers who were randomized into three groups: two that received different dose levels of the drug, and one that received placebo pills over six months. At the end of the study, researchers found that the group receiving the highest dosage had reductions in two key signs of kidney damage compared to the placebo group. The findings are a first step in determining whether Baricitinib or another drug that targets the JAK-STAT system could help treat T1D-releated kidney disease.

In other research, investigators at the Joslin Diabetes Center have teased out a potential correlation between the levels of endothelial progenitor cells (EPC)—which work to repair various organs—in the kidneys, and the development of kidney disease. The research team looked at samples taken from 172 volunteers in the Joslin Medalist group and compared whether their levels of circulating EPC matched their kidney function. They found that EPC levels were consistently higher in volunteers with good kidney function than in those with declining function. The findings suggest that reduced EPC levels could be an early biomarker for T1D-related kidney disease. While this research is still in the early stages, investigators said it points to a potential means for stopping or reversing kidney disease by restoring EPC levels.

Investigators from a project led by JDRF-supported researcher Linda Hiraki, M.D., presented findings from a study that is endeavoring to pinpoint genes that might play a role in promoting kidney disease in people with T1D. The team sorted through the genes of approximately 2,700 individuals with T1D-related kidney disease in an attempt to identify a genetic similarity that might play a role in the development of this complication. They found that the vast majority lacked a gene known as GPBP1. If researchers are able to validate a correlation between this deletion and the development of T1D-related kidney disease, they may be able to develop a targeted therapy for preventing or reversing this complication.