The destruction of beta cells in T1D is normally not detected until a significant loss of beta cell mass has occurred and glucose control is affected. A clinical test to detect beta cell loss would help to diagnose T1D before loss of glycemic control and to demonstrate effectiveness of therapies aimed at protecting beta cells in clinical trials. These investigators developed a new method to detect beta cell death by looking for DNA released by dying beta cells into the blood. The test takes advantage of specific modifications that occur on the insulin gene in beta cells. Using this blood test, the team has been able to detect beta cell death prior to the onset of diabetes in mouse models of the disease and preliminary results from individuals with new-onset diabetes suggest that the assay could also be useful for detecting death of beta cells in people. This work represents the first non-invasive method to detect the loss of beta cells in living animals and, if successfully translated to humans, would be useful in diagnosing T1D as well as tailoring therapies and proving the effectiveness of therapies aimed at promoting beta cell health in the at-risk and new-onset T1D populations.
Akirav, EM., Lebastchi, J., Galvan, EM., Henegariu, O., Akirav, M., Ablamunits, V., Lizardi, PM, and Herold, KC. (2011). Detection of beta cell death in diabetes using differentially methylated circulating DNA. Proc. Natl. Acad. Sci. USA. 108, 19018-19023.
Ramifications for Individuals with Type 1 Diabetes:
This work provides the proof-of-concept for a test that detects beta cell-specific DNA in the blood can be used to monitor beta cell destruction. Further work will be required to optimize the test and validate its utility in humans with T1D. If fully validated, this blood test could be used to diagnose T1D, stratify patients for treatment and demonstrate the effectiveness of new therapies aimed at preserving beta cells in individuals at early stages of T1D.
This study was funded in part by a JDRF grant to Dr. Herold that was made possible by the Lilly Foundation.