Ira Pastor, ideaXme exponential health ambassador and founder of Bioquark, interviews Dr. Denise Faustman, Associate Professor of Medicine at Harvard University and Director of the Immunobiology Laboratory at Massachusetts General Hospital.
Ira Pastor comments:
Over the last several shows we have spent time on different hierarchical levels regarding the biological architecture of the life and aging processes. We’ve spent some time talking about the genome, the microbiome, the extracellular matrix, and systems biology.
However, we can’t forget that while all these integrated and varied biologic processes are important in the maintenance of our daily health and wellness, that when things go wrong, the trickle down is unfortunately a wide range of chronic degenerative disorders responsible for human suffering and death, and an annual global healthcare expenditure of over $7 trillion.
Diabetes
One of the major groups of pathologies responsible for a piece of that figure in 2019 remains diabetes, a group of metabolic and endocrinologic pathologies affecting over 350 million patients worldwide and projected by the World Health Organisation to surpass the 500 million patient mark within the next two decades. The global economic cost of diabetes medical costs and reduced productivity was estimated in 2018 to be between $3 – 4 trillion.
Type 1 Diabetes (T1D), also known as Juvenile Diabetes, is a form of diabetes in which very little or no insulin is produced by the pancreas. While the cause of Type 1 Diabetes is still unknown, it is believed to involve a combination of genetic and environmental factors, and the underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.
Diabetic complications, including retinopathy, nephropathy, neuropathy, and cardiovascular disease are the major causes of morbidity and mortality in T1D, as well as severe hypoglycemia and diabetic ketoacidosis which are also associated with high mortality rates, particularly in younger patients.
And in addition to diet and lifestyle changes, and oral hypoglycemic agents (primarily used in Type 2 Diabetes), the core pharmacotherapeutic interventions for active T1D disease in 2019 remains replacement injections of insulin, a medication first approved close to 100 years ago in 1922.
On a past show we touched on some translational work in the area of exogenous replacement of pancreatic islets and discussed the topic of stem cells.
Dr. Denise Faustman
Today, with our guest, we are going to explore an entirely new angle of intervention against this substantial unmet medical need, looking at novel technologies and interventions for inducing endogenous repair and regeneration of the pancreas via novel tools for immune-modulation, which may have wide reaching implications not just in diabetes, but a range of autoimmune disorders, as well as cancer.
Dr. Denise Faustman, with an MD and Ph.D. in transplantation immunology, is Associate Professor of Medicine at Harvard University and Director of the Immunobiology Laboratory at Massachusetts General Hospital. Her work specializes in both Diabetes Mellitus Type 1, as well as other autoimmune diseases. Her team is seeking to develop novel and potentially curative treatments based on the endogenous regeneration of critical organs (like the pancreas) that occurs after autoimmunity is removed.
Bacillus Calmette-Gurin (BCG)
For the last 20 years, the Faustman Lab has been the leader in investigating the potential of the Bacillus Calmette-Gurin (BCG) vaccine (a vaccine primarily used for tuberculosis treatment and occasionally in bladder cancer) to prevent and reverse autoimmune diseases including Type 1 Diabetes.
This research has advanced from early mouse studies, moving to mechanistic, in vitro trials and now a multi-trial human clinical research program. The Faustman lab showed that BCG boosts a cytokine called TNF, which is beneficial in autoimmune diseases by directly eliminating the autoreactive T cells that attack the pancreas, as well as by inducing beneficial immune cells called regulatory T cells (Tregs).
In 2018, her lab announced long term data on BCG treated patients followed for more than five years. All of the patients in the studies showed a durable and significant improvement in Hemoglobin A1c.
In addition to all of this, the Faustman Lab is also involved in the application of their accumulated knowledge in oncology and other auto-immune disorders, a cumulative class of diseases that also affects 100s of millions of patients globally.
On the show we will hear from Dr. Faustman:
Her background and how she became interested in science, medicine, immunology, and eventually into this fascinating area of diabetes therapeutics. What it’s like to challenge decades of ingrained medical doctrine in a specific disease class. About the BCG vaccine, its mechanism of immunomodulation, and its connection to auto-immunity via the hygiene “hypothesis of chronic disease.” Finally, we’ll learn about her future clinical plans moving forward in diabetes and other diseases.
Credits: Ira Pastor interview video, text, and audio.
Follow Ira Pastor on Twitter: @IraSamuelPastor
If you liked this interview, be sure to check out our interview with Dr. Camillo Ricordi, Director Diabetes Research Institute University of Miami!
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