new treatments

Killing T Cells to Cure Diabetes

David Mendosa Health Guide December 21, 2008


    Even if you have type 1 diabetes, you almost certainly still have some of your beta cells. If your body stops killing them, they will replicate and produce insulin -- and then you will possibly have a cure.


    The problem is that diabetes is an auto-immune disease. Our own immune system kills our beta cells. And it's not just type 1 that is an auto-immune disease.

    "We have a lot of evidence that both type 1 and type 2 diabetes are autoimmune disorders," Dr. Bernstein told me. "And even aged type 1s upon autopsy are found to have some surviving beta cells that are capable of replication."

    Our beta cells would replicate if we could kill the agents of our immune systems called "killer T cells." Many researchers are hard at work trying to figure out how to destroy them in hopes that they can thereby cure diabetes. Most well known is Denise Faustman, associate professor of medicine at Harvard University.

    "She is assuming that a fairly broad class of killer t cells -- called CD8 -- includes the culprit killer t cell that is responsible for diabetes," Dr. Bernstein says. "She says in effect that if you wipe out all the CD8 cells, you'll catch the killer t cells responsible for diabetes."

    But Dr. Faustman's approach is fraught with danger. "One problem with her technique of going after the whole category of killer t cells is that you render the patient immuno-incompetent," he says. "You are doing too much damage -- you are not doing focused damage."

    I suggest that Dr. Faustman's technique would leave us susceptible to all sorts of infections. "Right," Dr. Bernstein replied. "And cancers."

    Dr. Bernstein is sure that a more targeted approach would cure diabetes without leaving our bodies at greater risk of infections and cancers. About five years ago Professor
    Itamar Raz, who heads the diabetes unit of Israel's Hadassah University Hospital., cornered Dr. Bernstein.

    They were at an informal dinner of a group of diabetologists. Dr. Raz told Dr. Bernstein that the only people who could give them any ideas were engineers. "He said, 'So maybe you can think about a cure for diabetes.'"

    "I said, OK," Dr. Bernstein recalled. "It took me two days to come up with an idea."

    His idea is a method for finding the killer t cells for type 1 diabetes, those for type 2, determining if they are the same or different, and if there are several types. "I have a method for finding out that's very simple, very straightforward," he told me. Then, when they find the appropriate killer t cells, they can either make an antibody against them or take a unique protein from them and vaccinate the people with it, just like with other diseases.

  • But he doesn't want me to publicize the exact method, because then no drug company would be interested in it, since they couldn't patent it. "It would just languish forever."

    So Dr. Bernstein needed to find an immunologist who knew how to carry out the protocol that he worked out. He asked around and "all the fingers pointed at"
    Nora Sarvetnick, Ph.D., who is now a professor at the University of Nebraska Medical School.

    "So I call this lady up and introduce myself," Dr. Bernstein recalls. "I cover the idea, and she says, 'Oh, my God! I have to have this project! That's really the way to it it, and I know exactly what to do to find those killer t cells. I don't know why I never thought of it or no one else ever thought of it.'"

    But she needed money. Maybe half a million dollars. Lately they haven't been in touch, because Dr. Bernstein says that he doesn't know how to raise money.

    "I don't like the idea of raising money for profit, because then you have to set up a corporation," he says. "And then who's going to be responsible for running the business? That I don't need."

    Now he is looking for investors. "If a venture capital firm came along that had a lot of money and was well regarded or alternatively a major donor, I would consider turning it over to them and letting them make a business out of it. But ideally I would want to treat this as a charity and give her institution the money earmarked for her, and let it roll."

    Here is where Dr. Bernstein's idea stands now. "I have the only idea for a cure for diabetes that is viable. Everything else that's going on is an utter waste of money. All of these islet cell transplants will be destroyed by the immune system as soon as they are transplanted."

    Dr. Bernstein ended our interview with this lament. "Here I am getting pretty on in years and sitting on a time-bomb that no one is interested in."

    So far.