New research has detected 9 ‘core’ genes linked to the immune system that have a significant role in the risk of type 1 diabetes.

These genes highlight the importance of immune system pathways because they are essential in the development of type 1 diabetes.

According to experts, these pathways will display new targets for immunotherapies to block type 1 diabetes from developing.

During the study, a team of researchers tested a new method of assessing which genes are at the root of type 1 diabetes risk.

They studied the genes of nearly 5,000 individuals with type 1 diabetes and 7,500 living without the condition. The research team also examined blood samples from the participants.

For the first time, the scientists identified nine new ‘core’ genes that significantly impacted type 1 diabetes risk.

All of the genes detected are linked to the immune system, with seven of them in charge of regulating the immune cells that attack the pancreas in type 1 diabetes.

The results also show that two of the genes are associated with part of the immune system’s first line of defence, responsible for detecting threats, such as bacteria or viruses, and launching an immediate attack. This is the first time that this part of the immune system has been linked to type 1 diabetes.

To prevent or slow down the development of the condition, these pathways could be targeted with immunotherapies – treatments that work to reprogramme the immune system.

Immunotherapies are a promising treatment avenue for type 1 diabetes, with the first ever immunotherapy that can delay onset of type 1 diabetes for up to three years – teplizumab – approved for use in the US last year.

Professor Paul McKeigue, at the University of Edinburgh, said: “At the beginning of the genome era in 2000, it was expected that the discovery of genes through which common variants cause disease, would rapidly lead to the development of new drugs.

“Until now researchers have studied the short-range effects of risk variants on nearby genes and found no obvious link to the risk of conditions or ways to treat them.

“Our study focused instead on the long-range effects of these risk variants on genes elsewhere on the genome. We have identified what appear to be ‘core’ genes for type 1 diabetes, some of which are potential therapeutic targets.”

Dr Elizabeth Robertson, Director of Research at Diabetes UK, which funded the study, noted: “Type 1 diabetes is a constant balancing act of blood sugar checks and insulin injections. We desperately need to find ways to prevent, delay and treat the condition, to spare hundreds of thousands of people the burden of managing their diabetes, day in, day out.

“This research has broken new ground in our understanding of genes that underpin type 1 diabetes, and how they contribute to the immune attack that causes the condition.

“The discovery that these ‘core’ immune system genes are central to the development of type 1 diabetes opens the door to a raft of new targets for immunotherapies that could prevent, delay or treat type 1 diabetes early on.”

She added: “With the first ever type 1 diabetes immunotherapy approved for use in the US last year, we are on the brink of a new era for type 1 diabetes therapies that could see it transformed from a lifelong condition to one that can be prevented, treated and ultimately cured.”

Read the full study in the American Journal of Human Genetics.

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