New imaging technology at Joslin shown to detect early signs of type 1 diabetes

BOSTON - By the time overt symptoms of type 1 diabetes appear in an individual, destruction of the insulin-producing beta cells of the pancreas has already progressed significantly. However, findings by researchers at Joslin Diabetes Center and Massachusetts General Hospital, published in the Aug. 24 issue of Proceedings of the National Academy of Sciences, show that a powerful new imaging technology gives scientists a glimpse into the earliest stages of the inflammatory process leading to type 1 diabetes in laboratory animals. The new findings one day may be useful for predicting whether and when diabetes will develop in humans.

Type 1 diabetes is an autoimmune disease in which the body's immune system mistakenly launches an attack on the insulin-producing beta cells of the pancreatic islets. This process may eventually destroy the beta cells, preventing them from producing sufficient insulin, so that high blood-glucose levels--and full-blown diabetes--develop. Early in this process, white blood cells called T-cells invade the islets (an inflammatory condition known as "insulitis"). A very early marker of this inflammation is increased permeability (leaking) of the tiny blood vessels surrounding and within the islets.

Until recently, the only way to track type 1 diabetes in its earliest stages was to measure blood levels of autoantibodies (the immune system's "guided missiles") directed against pancreatic islet proteins. Yet, these tests are only an indirect indication of the disease process, and don't allow researchers to directly follow the progression of disease.

This gap may someday be filled by a new technology that exploits magnetic resonance imaging, commonly known as MRI, to monitor miniscule magnetic nanoparticles leaking from the blood vessels of the pancreas, according to Maria Denis, Ph.D., Christophe Benoist, M.D., Ph.D., and Diane Mathis, Ph.D., of Joslin Diabetes Center, and Umar Mahmood, M.D., Ph.D.


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