Bryan Goodchild, UMass Medical School

Annie Kruger

Scientists at UMass Medical School have identified what may be a type 1 diabetes biomarker—a substance or compound used to gauge the health and function of a cell or organ—linked to a response from a viral infection. This discovery, coupled with known genetic markers for the disease, could help identify the disease in its earliest stage, when potential treatments may be most effective.

Accurate and efficient biomarkers provide physicians with a powerful medical tool for early detection and treatment of diseases. In the case of type 1 diabetes—an autoimmune disease that causes the body’s own immune system to attack and destroy the pancreatic islet cells that produce insulin needed to convert sugar in food to energy—the advent of new therapies that could help control the body’s immune response has led to a heightened demand for noninvasive, testable biomarkers that can identify the early development of the disease. In a study published in the November issue of Experimental Biology and Medicine, researchers identified increases in a blood serum protein that occurs in the early stages of type 1 diabetes, after exposure to a virus but before clinical signs of diabetes appear.

It’s not known why the immune system attacks the islet cells in people who have type 1 diabetes, formerly known as juvenile diabetes. Type 1 diabetes risk is known to depend upon genetic predisposition, but the age of onset may vary from infancy to adulthood—and not all those who are genetically susceptible develop the disease. This suggests that environmental factors, such as a viral infection, may be responsible for setting off the disease in genetically susceptible individuals. Indeed, a number of viral infections, including mumps, rubella and enteroviruses have been associated with human type 1 diabetes.

“We know that people with genetic susceptibility are prone to the condition,” said Rita Bortell, PhD, associate professor of medicine and lead author of the study. “If there was a way to reliably identify children in the earliest phases of diabetes (pre-diabetes), after exposure to a virus, that may provide clinicians with a window of opportunity when pharmacological interventions could be most effective in slowing or halting the disease.”

Using protein profiling technology available at UMass Medical School, Dr. Bortell and MD/PhD student Annie Kruger scanned the blood serum of animal models infected with a virus known to trigger type 1 diabetes for common traits that could be used in predicting the development of the disease. What they found were sustained elevations of the protein haptoglobin. In their study, they showed that the elevated levels of haptoglobin could be identified less than a week following infection and well prior to the development of diabetes.

This discovery, combined with known genetic markers for the disease, may help to identify children at the highest risk for type 1 diabetes. “Type 1 diabetes generally occurs very early in life, and globally carries a very high morbidity rate,” said Kruger. “The potential to detect and treat the disease early in its development would give clinicians a huge advantage in slowing its progression.”