Personal Experience with New T1D Study

Hi Jan,

I posted a reply to a similar post of yours over on CWD, but I don’t think you saw it. This is pretty much the same reply.

Jan, can you explain this is a little further? As far as I know, all people with type 1 have the exact same type of T cell in circulation that attacks the beta cells. Dr. Faustman has been identifying and measuring these T cells in the blood of people with T1 for at least 5 years. This is why she collects blood samples from T1 people, as the OP has done. She has blood from controls (people who don’t have diabetes or any other autoimmune disease) for comparison.

Can you find out what your endo is referring to? The immune system is incredibly complicated and confusing to understand in detail. The T cells that actively attack the beta cells in the pancreas are the CD8 type of T cell. Faustman refers to these as the “memory” T cells when she explains the process to people.

There’s another type of T cell called a CD4, but they don’t attack the beta cells. The CD4 cells function as trainers and screeners of CD8 T cells. So, the CD4 T cells present what’s called self peptide to the CD8s to teach them not to attack the body’s own tissues. This happens at the bone marrow and thymus level. In diabetes, the CD4 T cells mess up too by allowing the bad CD8s out in circulation. But once all those CD8s are taken out by a drug treatment, like BCG, no one knows if or when or how long it might be before the CD4s allow bad CD8’s out again. So, the BCG treatment might be very long lasting in some people and need to repeated in others at intervals. No one knows and that’s what Phase II trials are all about. But from my understanding, only the CD8-type T cells actively attack the pancreas (and only a sub-population of them, since the other CD8 T cells function just fine to protect the body from disease) and all people with T1 have the same faulty T cells. In fact, NOD mice has the same exact defect in the same biochemical pathway of their CD8 cells.

Is is possible that your endo is getting autoantibodies confused with T cells? Most docs forget immunology once they’re in practice and don’t learn it at a very detailed level in school – not like a researcher in immunology.


You’ve done a great summary, Marps!
We gave our daughter BCG back in the 1950s when we were going to be living in Ferkessedougou, Cote d’Ivoire, at that time a high tuberculosis area. Our daughter never had any side effects from it.
Best wishes to you as you’ve participated in this study.
I hope Dr. Faustman gets all the numbers she needs - this has real potential. Those T cells need suppression. Eradication would be nice, too.

Marps,

I signed up to donate blood & to help with fundraising. Dr. Faustman’s staff got in touch promptly. They’ll be scheduling appts again soon with appointments starting in Sept., so don’t know when mine will be yet.

The donation form states that the donation goes to MGH. No mention of Dr. Faustman at all. I would like to make a targeted donation towards Dr. Faustman’s research lab. Any advice?

Please don’t take this as overly negative. I am glad this research is being done and like everyone here I hope that it is successful.

But this is by no means a solved problem with a clear likelihood of success. I read her original papers several years ago, and it is not at all clear why temporarily wiping out some T cells (and this is not targeted only at “bad” T cells) would prevent them coming back (especially when the BCG dose given to humans has to be substantially less than the dose of CFA given to mice). And if anything, there are a lot of questions as to why the previous trials injecting BCG have not been effective in reversing T1 diabetes in people - even when tested on those newly diagnosed with T1. The answer could, as Faustman suggests, be due to dosing or purity issues. But it could also be because mice and people are just fundamentally different.

This article presents both possibilities in an easy to understand way: http://www.usnews.com/health/family-health/diabetes/articles/2009/0…