Pathways

There is extensive research underway around the world in three main areas relating to type 1 diabetes -- beta cells, T-cells, and Tregs.

• Beta cells make and release insulin, a hormone that controls the level of glucose in the blood.
• T-cells belong to a group of white blood cells known as lymphocytes, and play a central role in cell-mediated immunity.
• Regulatory T cells (sometimes known as suppressor T cells) are a specialized subpopulation of T cells that act to suppress activation of the immune system and thereby maintain immune system homeostasis and tolerance to self-antigens.

Instead of focusing on one area, the Brehm Coalition scientists are working on novel, multi-year scientific goals that are broken down into smaller collaborative projects between the immunologists and beta cell biologists.

1. Band the Coalition PIs together to explore dual (or multiple) pathways combining immunology and beta cell biology, addressing multiple factors, in a closely collaborative manner, as though in one lab.
2. Immunology Pathways focusing on:
   1. Eliminating or conditioning T-Cells that mount the autoimmune attack on the beta cells through development of a vaccine
   2. Designing a Treg cell that can moderate the actions of the T-Cells
3. Beta Cell Biology focusing on:
   1. Finding factors that promote beta cell differentiation and survival.
   2. Discovering reasons for failure of the cells as well as ways to cause precursor cells to differentiate into beta-like cells that produce insulin.
   3. Seeking to derive beta cells from clonal precursors as well as beta cells that may be regenerating in the pancreas after genetic or physiological suppression.
4. Structure the Pathways enough to monitor but not so rigidly as to be dominated by a single thread.
5. Foster side studies by associates to explore the boundaries.
6. Target a combination therapy solution that could be both safer and earlier.