Finnish Team Makes Diabetes Vaccine Breakthrough

jones_supa writes "A team working at Tampere University, Finland has discovered the virus that causes type 1 diabetes. The enterovirus penetrates the pancreas and destroys insulin-producing cells, eventually causing diabetes. Researchers have looked at more than a hundred different strains of the virus and pinpointed five that could cause diabetes. They believe they could produce a vaccine against those strains. One virus type has been identified to carry the biggest risk. A vaccine could also protect against its close relatives, to give the best possible effect. A similar enterovirus causes polio, which has been almost eradicated in many parts of the world thanks to vaccination programmes. A prototype diabetes vaccine has already been produced and tested on animals. Taking the vaccine through a clinical trial would cost some 700 million euros. Some funding is in place from the United States and from Europe, but more is required. Professor Heikki Hyöty says that money is the biggest obstacle in moving to testing in humans, but he sees that people are interested in their research and that the funding problems will ultimately be solved."

Comments

Not much info

[Okian Warrior]

I nodded this in the firehose because it looked interesting.

There's not much information in the linked article. Can anyone give us more info? Anyone who reads Finnish care to comment on the source - is it reliable, are the researchers legitimate?

Re:Not much info

[gl4ss]

it sounds legitimate. finnish articles don't have that much more info. they're gathering money for trials. but the source in finnish medical scene should be treated legitimate from what I know(it's a well known big university in Finland, from Finlands 2nd biggest city). diabetes-alliance(not probably best translation..) treats it as legitimate, the mentioned prof admits that so far it is not water tight connection yet. it's related to gene sampling and following of kids with high risk of diabetes 1, that project starting back in 1994.

there's two things in play, the virus and a genetic factor(a risk gene, which is supposed to fight the virus).

more info in finnish:
http://www.diabetes.fi/diabetesliitto/lehdet/diabetes-lehden_juttuarkisto/diabeteksen_ehkaisy/enterovirusten_salat_aukenevat.2246.news

earlier stuff on the connection between the virus has been published in british medical journal, fwiw.

Re:Not much info

[niftydude]

The journal paper the news article is based on seems to be here: http://diabetes.diabetesjournals.org/content/early/2013/08/30/db13-0620.short

Abstract:

Enteroviruses have been connected to type 1 diabetes in various studies. The current study evaluates the association between specific enterovirus subtypes and type 1 diabetes by measuring type-specific antibodies against the group B coxsackieviruses (CBV) which has been linked to diabetes in previous surveys. Altogether 249 children with newly diagnosed type 1 diabetes and 249 control children matched according to sampling time, gender, age and country were recruited in Finland, Sweden, England, France and Greece during the years 2001-2005 (mean age 9 years; 55 % boys). Antibodies against CBV1 were more frequent among diabetic children than in control children (OR=1.7, 95%CI=1.0-2.9) while other CBV types did not differ between the groups. CBV1-associated risk was not related to HLA genotype, age or gender. Finnish children had lower frequency of CBV antibodies than children in other countries. The results support previous studies suggesting an association between group B coxsackieviruses and type 1 diabetes, highlighting the possible role of CBV1 as a diabetogenic virus type.

Re:Not much info

[pepty]

has discovered the virus that causes type 1 diabetes.

Already a problem right there, though it might be in translation. There are several viruses known to trigger the autoimmune response that generally causes type 1 diabetes.

Re:Not much info

[gl4ss]

multiple similar enteroviruses, according to the articles. they're developing a vaccine for the most common one which may or may not also work for it's relatives...

Re:Not much info

[nbauman]

it sounds legitimate.

I review stuff like this for a living. This does look like a legitimate, promising study.

The guy has done a lot of research. http://www.ncbi.nlm.nih.gov/pubmed/?term=Hy%C3%B6ty%2C+Heikki%5BAuthor+-+Full%5D

TFA doesn't say what the virus is, but I guess that it's group B coxsackievirus 1. https://en.wikipedia.org/wiki/Coxsackie_B_virus#Diabetes that Hyöty was working on.

That said, it's a mouse study. I always used to say, "Mice, humans, what's the difference? We're all mammals, right?"

Then a researcher at Rockefeller University clued me in. "Humans are not big mice."

As the saying goes, "We've cured cancer in mice a million times."

It's great to model a disease in mice. But the diabetes type I they model in mice might not be the same as type I diabetes in humans. Probably for every 10 mouse studies, 1 holds up in humans. And for every 10 human studies, 1 turns out to be actually useful against the disease.

But hey, this is immunology. When it comes down to what causes a disease like diabetes type I, nobody really knows, so 1 in 100 is pretty good odds.

If you have 100 researchers working on it, you've got a pretty good chance that somebody will get it.

Diabetes type I is an autoimmune disease. You get exposed to a trigger, your immune system goes after the trigger, but it also starts attacking other things. In diabetes type I, it attacks the beta cells of the pancreas, which produce insulin. https://en.wikipedia.org/wiki/Diabetes_Type_I The trigger might be a virus, or it might be something else. Hyöty thinks it's a virus, in fact group B coxsackievirus 1. If he can prove that it is a virus and he's identified it (in humans, not just mice), he'll be doing pretty good.

And if Hyöty can come up with a vaccine that will prevent coxsackievirus infection in humans, we can give it to kids and they'll never get diabetes type I. That will be great. I hope it works.

”We know that this vaccine is effective in mice,” noted Hyöty. ”It is important to test it in people, so that we can be sure that the vaccine prevents diabetes.

That's the important qualification. If he's ready to go to test it in humans, that's pretty good. But he's still got a long way to go. And a lot of vaccines don't make it.

Taking the vaccine through a clinical trial would cost some 700 million euros. Some funding is in place from the United States and from Europe, but more is required.

Oh, give him the money. We've wasted E700 million on a lot of stupider things that you could probably think of.

If this vaccine is promising, then the big pharmaceutical companies will probably spot him E700 million for clinical trials (although that does seem a bit high). If it really does prevent type I diabetes, it should be a successful vaccine.

Re:Not much info

[Novus]

That's almost certainly a translation error. The University of Tampere press release states that "these studies clearly show that members of the group B coxsackieviruses are associated with the risk of type 1 diabetes", and the offending sentence in the Yle article would be the same in Finnish irrespective of whether the virus found is the only one or not (e.g. "löytänyt viruksen" would be "discovered a/the virus"). Finnish grammar doesn't have the concept of definiteness, meaning that a translator working from a Finnish source text would in many cases have to guess the intended meaning or look it up elsewhere. For similar reasons, many Finns have problems figuring out whether to use a definite or indefinite article when writing in English.

Re:Not much info

[dinfinity]

Imagine living in a town called that: "The virus family he discovered was eventually given the name Coxsackie, for the town of Coxsackie, New York, a small town on the Hudson River where Dalldorf had obtained the first fecal specimens.[3]"
"The village name is a native word mak-kachs-hack-ing, and when purchased by the Dutch settlers was written as Koxhackung.[1] It is generally translated as "Hoot-owl place"[2] or "place of many owls"."

But I'm pretty sure Dalldorf et al didn't care about the latter and still giggle when hearing their peers say Coxsackievirus.

Re:Not much info

[jones_supa]

There was also recently someone in /r/learnprogramming who was new to C++ and his first impression was that std::cout << "Hello world"; looks just like "count your STDs and tell the whole world".

Re:Not much info

[Joining Yet Again]

The great thing about the C++ Hello World example is that it simultaneously shows everything that's nice and everything that's horrible about C++.

Re:Not much info

[jones_supa]

Submitter here. I was able to locate the Finnish version from YLE News website. There is indeed a possibility for that kind of translation error. I'll try to retranslate the top part:

A virus is being uncovered behind type I diabetes, a disease found especially in children. In particular, it is an enterovirus, which invades the pancreas and destroys the cells producing insuline. A vaccine against the viruses can be created.

There are over hundred of various enteroviruses. A research team conducted by virology professor Heikki Hyöty has gone through all the strains and has been able to mark out five of them which cause diabetes. They can be compiled into a vaccine.

"We have recognized one type of virus which carries the biggest risk factor. We could also put its relatives into the vaccine, to get the best possible effect", says professor Hyöty from University of Tampere.

Re:Not much info

[Andy Dodd]

Thing is: The virus doesn't directly cause much damage to the pancreas. The theory here is that it causes the immune system to start attacking the pancreas (maybe due to similar antigens between beta cells and the virus???)

Tuning the immune system to more aggressively attack the virus might instead cause Type I diabetes here...

progress is good

[Gravis Zero]

progress toward making a vaccine is good and all but when will they finnish it. ;)

Re:progress is good

[NoMaster]

... but when will they finnish it. ;)

There's norway to know; it'll be dane when they're sweden ready.

Re:progress is good

[Pranadevil2k]

Europe on that high horse, huh? When they put a release date on this, denmark your calendars.

THE virus is a bit of an overstatement

[kyle3489]

A great advancement, but there are undoubtedly many causes of type 1 diabetes, many of which have been described in the scientific literature. Just a little bit of an overstatement to say, "the virus that causes type 1 diabetes," has been discovered.

Re:THE virus is a bit of an overstatement

[kyle3489]

That would be type 2 diabetes. Some of the already-described causes of type 1 are genetic (as opposed to this virus).

Re:THE virus is a bit of an overstatement

[I'm New Around Here]

Myth: eating too much sugar causes diabetes

Do you guys even bother reading your own links?

Myth: Eating too much sugar causes diabetes.

Fact: The answer is not so simple. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease [editor: we know this, that isn't what the debate is about]; type 2 diabetes is caused by genetics and lifestyle factors.

Being overweight does increase your risk for developing type 2 diabetes, and a diet high in calories from any source contributes to weight gain. Research has shown that drinking sugary drinks is linked to type 2 diabetes.

The American Diabetes Association recommends that people should limit their intake of sugar-sweetened beverages to help prevent diabetes. Sugar-sweetened beverages include beverages like:

        regular soda
        fruit punch
        fruit drinks
        energy drinks
        sports drinks
        sweet tea
        other sugary drinks.

These will raise blood glucose and can provide several hundred calories in just one serving!

Rubycodez isn't saying a certain amount of sugar directly causes diabetes in all cases. He is saying consuming large amounts of sugar is tied to the onset of diabetes. Which is what the American Diabetes Association also says.

Re:THE virus is a bit of an overstatement

[definate]

When in Rome.

Do you guys even bother reading your own links?

...type 2 diabetes is caused by genetics and lifestyle factors.

Anonymous Coward is correctly pointing out that while it's linked, the actual relationship is more complicated than that, and that is why "Eating too much sugar causes diabetes" is a myth. Rubycodez was making a joke and hence his comments shouldn't be taken that seriously, however the joke did rely upon the myth that consuming too much sugar causes diabetes, otherwise his joke wouldn't make sense. That is why Anonymous Coward's link was relevant.

Re:THE virus is a bit of an overstatement

[I'm New Around Here]

When in Rome.

Hey, you should be speaking Italian after that line. :^)

I understand there is confusion and misinformation in regards to diabetes in general. I won't attempt to claim to be an expert. But I don't accept the "myth" status regarding high sugar intake, when the myth-busting article itself admits there is a link. I don't accept it because it takes the most precise meaning of "x causes y" as an absolute, then in very inabsolute terms explains that the topic isn't well understood.

As I asked above, do we doubt the link between smoking and cancer, just because not all smokers get lung cancer?

Also, as Bitsy said and I agreed with, they should really call these conditions by different names. Make 'diabetes' be the condition when the pancreas isn't producing insulin because of damage from a virus (which generally happens at a young age), as the original story is about. Come up with a different name for when the body has become insulin-resistant due to dietary issues and lack of exercise. Then at least one more term for when the body isn't processing insulin correctly for other reasons, which may include results of an unrelated illness or a car accident.

They are medically different conditions, so why do they have the same name? They have half a dozen different terms for 'heart attack', which all have to do with one organ, but they can't come up with another term for "something's wrong with the patient's insulin".

Type 1 v Type 2 diabetes

[timeOday]

It is worth noting this is for type 1 diabetes, not type 2 which is the modern plague resulting largely from bad diet and inactivity. That said, if you know somebody for whom diabetes is a lifelong affliction since childhood, and kids who need shots for diabetes, that's type 1. A cure would be a huge deal.

Re:Type 1 v Type 2 diabetes

[Anonymous Coward]

A cure would be a huge deal.

Fortunately for potential, future, type 1 diabetics, this is a vector for prevention. Unfortunately for those of us who are already type 1 diabetics, this does not appear to be a cure.

The key to type 1 is that it is a disease of the immune system. If this virus actually caused diabetes, then diabetes would be a communicable disease, and everyone who got exposed to the virus would become diabetic. Instead, the disease is genetically inherited and only expresses itself if the person is exposed to a certain class of virus. What this virus does is elicit an immune response from people. In a small percentage of people who have inherited a defect in their immune system, their bodies react by producing antibodies that do not just kill off the virus in question, but also kill off the insulin producing beta cells in the pancreas. It appears that these researchers have found that class of virus, but it is the diabetics immune response to the viruses that kills insulin production.

If you inherit the defect, and don't ever get exposed to the virus, you don't become diabetic. If you are exposed to the virus and aren't genetically keyed to produce these T-cells that are lethal to your insulin producing cells, then you don't become diabetic.

I became a type 1 at 28, after I was sick for a week. My father became type 1 at 32. They used to call it Juvenile Diabetes, but obviously that is a misnomer. The later you get exposed to the virus, the later you become diabetic.

Re:Type 1 v Type 2 diabetes

[mpe]

It is worth noting this is for type 1 diabetes, not type 2 which is the modern plague resulting largely from bad diet and inactivity. That said, if you know somebody for whom diabetes is a lifelong affliction since childhood, and kids who need shots for diabetes, that's type 1.

Genetics appears to be a strong factor in ALL forms of diabetes.
As for "bad diet" this may well be the low fat, but very high glucose, diet pushed as "healthy" since the late 1970's (in the US). Given that diabetes is the inability to effectivly handle dietary glucose.

Re:Type 1 v Type 2 diabetes

[mpe]

I became a type 1 at 28, after I was sick for a week. My father became type 1 at 32. They used to call it Juvenile Diabetes, but obviously that is a misnomer. The later you get exposed to the virus, the later you become diabetic.

Similarly T2 used to be called "Mature Onset Diabetes". Thus you end up with terms such as Latent Autoimmune Diabetes of Adulthood (LADA) and Maturity Onset Diabetes of the Young (MODY). IIRC the oldest person diagnosed T1 was in their 90's and the youngest person diagnosed T2 around 7.
It turns out than many people with MODY actually have a mitochondial abnormaility. Whilst this produces "insulin resistance" the biochemical mechanism is different.

Re:And i might see it in my lifetime.

[maroberts]

What was the last billion dollar industry that let itself go obsolete?

Slave trading.

It didn't go obselete, it just implemented a different business model.

This has been suspected for some time...

[aussie.virologist]

There is a significant body of literature attempting to associate the onset of type 1 diabetes with infection by members of the species B enteroviruses, specifically CVB's (Coxsackieviruses B1 to B6) , if you search pubmed you will find hundreds of manuscripts. The problem has been nailing down a definitive causal relationship, from my understanding it is thought that there may be an element of molecular mimicry involved in the disease (or something similar). Essentially the virus infects the host and damages specific parts of the pancreas, the host's immune system mounts a response to the insult, but in the process creates antibodies that target the hosts own islet cells, resulting in the autoimmune disease that is type 1 diabetes. The problem of definitively implicating CVB's for type 1 diabetes is similar in some ways to that of other enterovirus infections like Polio. Basically there are other host mediated issues at play but with Polio you are able to detect the virus around the time of infection, with diabetes the disease presents after the infection has been cleared, complicating matters. To this day we still don't understand why only about 1% of people infected with Polio will develop paralysis, whilst the majority of people ~95% will show no significant signs of illness. Host factors are really important and not fully understood, there may even be a role for certain bacteria in the gut assisting the infection!
As a side note there has been some recent rumblings about the possibility of viral infections triggering transient type 2 diabetes, I can't link to any papers at the moment (too busy at work) but if anyone is interested I can have a dig around later.
Hopefully the vaccine is able to account for the amount of drift in the enterovirus genome that occurs at up to ~1% per annum, a similar problem exists with the new enterovirus 71 vaccine, an emerging bug similar in presentation to Polio.

What about P2RX7?

[slew]

P2RX7 was all the hype back in January. Here's a blog entry on it... Or the paper abstract for the more technically inclined (pay-wall for paper)...

If people are interested, I think there is some more info in English concerning the earlier Tampere research here (for free)...

Sometimes it's hard to predict what is going to work in bio-science just by seeing the techno-press response. Although polio is caused by an Enterovirus, so is the common cold (the variety caused by a Rhinovirus). Generally you get Enterovirus infections orally. Some Enteroviruses can eventually enter the bloodstream and infect other organs.

Apparently, the Tampere study looked at the small-bowel mucosal biopsies of 120 patients and did a PCR technique to assess if there was likely a Enterovirus infection. 74% of people with type 1 diabetes tested positive, compared with 29% of the non-diabetic ones. On that basis they conclude that a persistent Enterovirus infection in the small-bowel might eventually spread to the pancreas where the on-going immune response might destroy the insulin producing cells leading to diabetes...

So, I wasn't totally impressed after reading that paper, but you never know...

Re:Isn't Type 1 largely genetic?

[Pranadevil2k]

The research suggests that the genetic predisposition causes the immune system to act different in response to the virus. If the research is correct, then yes you need both the genetic factor and the virus to get type-1 diabetes. Of course, that completely discounts any other possible methods of 'catching' the disease. Since it is an autoimmune disorder, there are likely multiple factors involved. If this pans out and cures the most common of those factors, it may still not eliminate the disease.

Re:Not much info -- check BBC/ProMed

[TheRealHocusLocus]

Best media reporting
http://news.bbc.co.uk/1/hi/health/7926026.stm

Most notable analysis (scroll to bottom, in square brackets)
http://www.promedmail.org/direct.php?id=20090308.0959

The ProMed moderator links to related background research, points out that there are 5 specie of Enterovirus distinct enough that one vaccine could not fit all, it is 'premature' to announce it this way until the particular agent and mechanism is identified.

So by all means forge ahead, but be prudently wary of anyone who implies this is in the final stage where a vaccine is just around the corner.

---
If we were to fund LFTR research with the same dedication and fervor that we funded the polio vaccine, America could be energy-independent within 30 years, forever. Off-topic, pretend it's my sig.

Re: And i might see it in my lifetime.

[jittles]

Type 2 diabetes comes with the occasional need for medications, a few doctor visits, and lifestyle changes.

I think you're confused.

Type 2 diabetes can progress to the stage where it is just as difficult to manage as Type 1. Your body can become resistant to medications such as glucophage and then you end up on insulin anyway. Glucophage doesn't even work for all Type 2 patients, some have to use insulin regardless. In fact, they have developed synthetic insulin that is very concentrated specifically for people with Type 2 diabetes. No I am not a doctor, but I know someone with severe Type 2 diabetes and I know an ICU doctor who has to deal with diabetics on a regular basis.