New breakthrough shows promise for protecting people against kidney damage in type 1 diabetes
Press release issued:
A new gene therapy approach aimed at protecting people with type 1 diabetes from developing diabetic kidney disease — a serious and common complication of the condition, has shown promising results in a University of Bristol study.
One in three people with type one diabetes will develop kidney damage during their lifetime, which can develop silently over many years, often going undetected until it becomes severe.
Current treatments can slow kidney damage but there are none that act on the root cause — a tiny filter called the glomerulus. Findings from this new study, part-funded by Diabetes UK and published in Molecular Therapy, demonstrated a 64% reduction in a damage indicator for kidney disease, paving the way for a potential new treatment.
The study, driven by first author, Dr Aldara Martin Alonso and led by Dr Rebecca Foster, Associate Professor of Microvascular Medicine at Bristol Medical School: Translational Health Sciences, explored the potential of delivering a protein called VEGF-C directly into kidney cells.
Previous studies have shown VEGFC could protect against kidney disease as it helps keeps blood vessels in the kidney filter healthy, repairing early signs of diabetes-related kidney damage.
To test whether this new approach could be used to treat or slow down kidney disease, the team used a harmless virus to deliver VEGF-C directly into the kidney cells of diabetic mice.
Their results showed that this approach not only helped the kidneys work better, but also protected a key part of the kidney filter that normally helps prevent damage. It led to a 64% reduction in albuminuria — the presence of a protein called albumin in the urine, which is a common sign of kidney disease. Importantly, this reduction is more than twice the reduction recommended by the American Diabetes Association to slow the progression of chronic kidney disease.
Dr Foster, the study's senior author, explained: “Currently, there are no drugs specifically available to protect people with type 1 diabetes from kidney disease, despite their higher risk of developing kidney disease. This gap in treatment highlights the urgent need for new therapeutic approaches. Our goal was to investigate whether gene therapy could offer a viable solution by delivering VEGFC in a more targeted way.”
Dr Faye Riley, Research Communications Lead at Diabetes UK, which part-funded the study, said: “Kidney disease is a serious and life-altering complication of diabetes, that can progress silently over many years. There is an urgent need for new treatments to prevent kidney damage in people with diabetes, and this novel approach tackles the root cause for the first time.
“While early stage, this promising research could lead to an entirely new way to protect the kidneys in people with diabetes and prevent devastating kidney failure.”
Dr Foster added: “This gene therapy approach has not been explored before in pre-clinical models and offers a long-term solution for these patients who are at risk of developing kidney disease.”
Type 1 diabetes is an autoimmune condition that affects around 400,000 people in the UK. The condition occurs when the immune system attacks and destroys the insulin-producing cells in the pancreas, meaning they produce very little, or no insulin.
About Diabetes UK 1. Diabetes UK’s aim is creating a world where diabetes can do no harm. Diabetes is the most devastating and fastest growing health crisis of our time, affecting more people than any other serious health condition in the UK - more than dementia and cancer combined. There is currently no known cure for any type of diabetes. With the right treatment, knowledge and support people living with diabetes can lead a long, full and healthy life. For more information about diabetes and the charity’s work, visit www.diabetes.org.uk
2. Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly. Without the support to manage it well, both type 1 and type 2 diabetes can lead to devastating complications. Diabetes is one of the leading causes of preventable sight loss in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.
3. People living with type 1 diabetes cannot produce insulin. About 8 per cent of people with diabetes have type 1. No one knows exactly what causes it, but a family history of type 1 increases the risk of developing it. Type 1 diabetes is not currently preventable. It’s the most common type of diabetes in children and young adults, starting suddenly and getting worse quickly. Type 1 diabetes is treated by multiple daily insulin doses – taken either by injections or via an insulin pump. It is also recommended to follow a healthy diet and take regular physical activity.
4. People living with type 2 diabetes don’t produce enough insulin or the insulin they produce doesn’t work properly (known as insulin resistance). Around 90 per cent of people with diabetes have type 2. They might get type 2 diabetes because family history, age and ethnic background puts them at increased risk. They are also more likely to get type 2 diabetes if they are living with obesity or overweight. People from the most deprived areas are also more at risk of developing type 2. It starts gradually, usually later in life, and it can be years before they realise they have it. However, we are seeing more young people, including children, developing it. Type 2 diabetes can be treated by getting support to manage your weight, eating a healthy diet and increasing physical activity. In addition, medications including tablets, insulin and non-insulin injectables are usually required.
5. About 2 per cent of people live with other types of diabetes. Other types include 11 different forms of monogenic diabetes, gestational diabetes, cystic fibrosis related diabetes and diabetes caused by rare syndromes. Certain medication such as steroids and antipsychotics, surgery or hormonal imbalances could also lead to other types of diabetes.
