December 24, 2006

Curing what was once incurable... DM1!

In the days of Hippocrates, there was very little that a doctor could do. They could recognize a few common diseases, treat the symptoms and announce its probable course.

One disease that once held a death sentence was diabetes mellitus. An old native term for it was "pissing evil," reminiscent of something diabolical... but a 2nd-century A.D. Greek physician, Aretus the Cappadocian, named it so because it was like a sweet siphon. 'Diabetes' means siphon and ‘mellitus’ means ‘honey.'

Diabetics have polyuria (excessive urine) and glucosuria (sugary urine) which attracted bees and flies. It used to be diagnosed by someone drinking a urine sample and going "Ooh, this is sweet! This means death." Unpleasant for the taster for sure... but I'm not sure how diabetics feel about finger pricks nowadays as a pleasant alternative.

Diabetes comes in two types, one in which autoantibodies attack the pancreatic cells that produce insulin (DM I)and the other in which the body starts becoming resistant to insulin (DM II.) The end result is that the body detects less insulin and cellular sugar intake drops, raising blood and urine glucose levels. This is a condition that we can only treat palliatively with medications, diet and exercise recommendations.

We do not have a magical cure for diabetes... but we have recently discovered how to cure DM I in mice!


TORONTO - Researchers at The Hospital for Sick Children (SickKids), the University of Calgary and The Jackson Laboratory, Bar Harbor, Maine have found that diabetes is controlled by abnormalities in the sensory nociceptor (pain-related) nerve endings in the pancreatic islet cells that produce insulin.
...
“We started to look at nervous system elements that seemed to play a role in Type 1 diabetes and found that specific sensory neurons are critical for islet immune attack in the pancreas,” said Dr. Hans Michael Dosch, study principal investigator, senior scientist at SickKids and professor of Paediatrics and Immunology at the University of Toronto. “These nerves secrete insufficient neuropeptides which sustain normal islet function, creating a vicious circle of progressive islet stress.”
...
Using diabetes-prone NOD mice, the gold-standard diabetes model, the research group learned how to treat the abnormality by supplying neuropeptides and even reversed established diabetes.

This is an amazing discovery that may lead to radically new treatment for this chronic disease that kills 72,815 people a year (6th leading cause of death in the U.S), not to mention that it can cause blindness, kidney disease and force people to be amputated.

Who knows. Someday, people may look back at our "dark ages," wondering why we didn't surgically remove sensory neurons expressing the receptor TRPV1 and supplementally treat with injections of substance P.

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