77th edition - March 2018

Scientists identify five subtypes of diabetes

Scientists have identified five subtypes of diabetes, a finding that will pave the way for more personalised treatments for the disease. The work, published in The Lancet Diabetes and Endocrinology, was funded in part by IMI through the projects BEAT-DKD and RHAPSODY. Currently, two main types of diabetes are recognised, and diagnosis is through a measurement of a patient’s blood sugar levels. In this study, scientists monitored over 13 000 newly-diagnosed diabetes patients, analysing blood sugar levels, insulin resistance, insulin secretion, and age of onset among other things. This revealed five distinct groups of patients with different risk levels for certain complications associated with diabetes. For example, patients in group 2 (‘severe insulin-deficient diabetes’) are at greatest risk of eye disease, while patients in group 3 (‘severe insulin-resistant diabetes’) had the highest incidence of kidney damage. ‘Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment,’ said Leif Groop of Lund University in Sweden. ‘This is the first step towards personalised treatment of diabetes.’ Until now, the team has only studied people in Sweden and Finland; they now plan to carry out similar studies in China and India, to see if their findings apply in different ethnic groups.

Study sheds new light on mechanisms behind type 1 diabetes

Scientists from the IMI project INNODIA have shed new light on the role of white blood cells and the thymus in the development of type 1 diabetes. The work is published in the journal Science Immunology. Type 1 diabetes is an autoimmune disease that occurs when the immune system destroys the pancreatic beta cells responsible for producing insulin, the hormone that regulates blood sugar levels. The immune cells that attack the beta cells are a sub-group of white blood cells called CD8+ T lymphocytes. T lymphocytes are created in the bone marrow and pass through an organ called the thymus before entering the blood stream. Scientists thought that the thymus presented T lymphocytes with fragments of proteins similar to those found in the beta cells of the pancreas; T lymphocytes that recognise the beta cell protein fragments are destroyed. They also thought that in people with type 1 diabetes, this process does not work properly, and the thymus allows auto-immune T lymphocytes that respond to beta cells to pass into the blood stream. However, in this latest study, scientists found that these auto-immune CD8+ T lymphocytes are found in similar numbers in the blood of both healthy people and people with diabetes. However, the team did find higher levels of the T lymphocytes in the pancreas of people with diabetes. The team believes that healthy people may be able to control these auto-immune T lymphocytes thanks to regulatory T lymphocytes. People with diabetes may lack this ability to control the auto-immune T lymphocytes; furthermore, if their pancreas is inflamed, this may make the beta cells even more ‘visible’ to the autoimmune T cells.

ONCOTRACK team identifies new way of tackling colon cancer

Scientists from IMI’s ONCOTRACK project have identified a new way of tackling colon cancer; their findings are published in the journal Cell Reports. Colon cancer is the third most common cancer and the fourth most common cause of cancer deaths worldwide. Research has shown that cancer stem cells, which multiply and differentiate into different cell types like normal stem cells, play a key role in driving the growth of colon cancer tumours. They are also thought to be behind relapses, when cancer returns following treatment. In this study, researchers studied the sequences of genes in cancer stem cells, and found a that cancer stem cell survival is controlled by a specific feature of the ‘Hedgehog’ signalling pathway which allows cells to respond to external signals and inhibits stem cell differentiation. Targeting the Hedgehog pathway in a similar way has delivered promising results in early-stage research on pancreatic and breast cancer cells. ‘The targeted inhibition of the Hedgehog signalling pathway, used in combination with other standard treatments to shrink tumours, may provide a new strategy for the elimination of cancer stem cells and the prevention of cancer recurrence,’ said the first author of the paper, Joseph Regan of the Charité Comprehensive Cancer Center. ‘Future research will set out to better define the downstream signalling components of the pathway and further investigate how Hedgehog signalling controls cancer stem cell survival.’

US Antibacterial Resistance Leadership Group joins COMBACTE studies

The Antibacterial Resistance Leadership Group (ARLG) has become the first US consortium to take part in clinical studies run by IMI’s COMBACTE programme on antimicrobial resistance. In a statement, the project described the news as a ‘major milestone’ that ‘clearly demonstrates the benefits of public-private collaboration and international collaboration between COMBACTE and ARLG’. The ARLG is joining two studies on treatments design to prevent pneumonia in people in intensive care who require a ventilator to help them breathe. The SAATELLITE study focuses on pneumonia caused by Staphylococcus aureus, while EVADE focuses on infections caused by Pseudomonas aeruginosa. Currently, 15 US sites are slated to participate in the trials; the first, in Detroit, was activated in January. ‘It is becoming increasingly common for hospitalised patients—especially those with weakened immune systems—to develop severe, hard-to-treat bacterial infections,’ said Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) which is supporting the ARLG’s participation in the studies. ‘These clinical trials […] are part of a global collaborative effort to explore innovative ways to mitigate the threat of antimicrobial resistance.’ Meanwhile COMBACTE-NET coordinator Hasan Jafri of MedImmune said: ‘We believe collaboration with world-renowned experts, such as those within COMBACTE and the ARLG, is one of the best models to advance development in this area, and bring novel and effective anti-infectives to patients.’

Sign up for the IMI-EMIF symposium

IMI’s EMIF project will hold a public symposium entitled ‘Liberating evidence from European health data – the achievements and challenges of a five year IMI project: EMIF’ on 18 April in Brussels, Belgium. The meeting will bring together a large variety of stakeholders to discuss issues such as the value of re-using healthcare data, how the new General Data Protection Regulation (GDPR) will affect the re-use of healthcare data, how to better involve patients, and how the healthcare data ecosystem will evolve. The day will also feature ample opportunities for networking.

Registration is free but obligatory – to sign up, fill in this form by 1 April.

More information can be found on the EMIF homepage and in this document.

ELF attracting attention even as it draws to a close

As one of IMI’s flagship projects, the European Lead Factory (ELF), continues to attract attention and has recently been featured as a success story on the European Commission website. Among other things, the article talks about how the demand for ELF services continues to grow and how the project is already helping Europe’s pharmaceutical sector deliver real progress. After five years of success, the project is now drawing to a close and will soon have its next stakeholder meeting, which will be held in Brussels, Belgium on 17 April 2018. Registration is still open.

IMI’s GetReal project: Faster access to better and safer medicines

A potential drawback of clinical trials of new drugs is that they do not always reflect how well these will work in the 'real world'. IMI's GetReal project broke ground in that it brought together companies, healthcare decision makers, patient representatives and other stakeholders to generate a consensus on best practice in the use of real-world evidence in drug development, as well as regulatory and reimbursement decision-making. It is hoped that the alternative evidence-generating strategies developed will deliver more focused research in pharmaceutical R&D and allow healthcare decision makers to be more confident when giving patients access to new treatments. ‘Uncertainty slows things down with regard to getting new medicines to market,' says Chris Chinn, GetReal’s deputy project coordinator. ‘Social and economic benefits should follow if we have been successful in helping individual research teams work with the healthcare decision makers to define evidence-based studies that ensure effective medicines have a smoother path to patients, freeing up research capital for other projects and ensuring patients start to benefit sooner.’ Read the full story

'EUPATI has been a game-changer in the empowerment of patients’ – an interview with the project coordinators

EUPATI built a much-needed programme for patient involvement in medicines research and development, and has been a game changer for patient empowerment in Europe, building a movement that will long outlive the project itself. In an interview with the IMI Programme Office, project coordinator Jan Geissler of the European Patients Forum, and Matthias Gottwald of Bayer explain how patients in Europe and beyond are benefitting from the work that was done. ‘EUPATI has been a game-changer in the empowerment of patients because we can see people trained by EUPATI almost everywhere, be it in regulatory committees, industry-led research projects and clinical trials, academic projects or ethics committees,’ said Geissler. ‘We can clearly see the difference that this empowerment makes. For example, before training patients are usually not involved in these kinds of committees and research projects, and after the training they suddenly get engaged. The final goal is to improve the outcomes for patients and that’s why involving patients in R&D, clinical trials design and regulatory decisions is absolutely crucial. We’ve achieved that and we can see a change already.’ Full interview