1-How did you get involved in T1D research?
After medical residency, I chose to pursue a career in medical research, and by chance this turned out to be in diabetes because of the availability of a fellowship in diabetes research.
My research was initially directed at studies of defects in insulin secretion by pancreatic islet beta cells that are the basis of type 2 diabetes. My research involved studies of beta cells in tissue culture and this led me to apply this methodology to study factors that might stimulate the beta cells to replicate and grow, the rationale being that we might grow enough beta cells to transplant them in patients with type 1 diabetes (T1D) who had lost their beta cells.
2-What were your most exciting projects?
Although I had identified several hormones that could stimulate replication and growth of beta cells, this did not amount to enough beta cell mass for transplantation into T1D patients. On the other hand, reports had begun to appear that beta cells could be regenerated from precursor cells lining the pancreatic ducts, thereby replicating the normal pathways of beta cell generation. This put me on to what I consider my most exciting projects, namely the discovery of drugs that regenerated beta cells, in vitro and in vivo in NOD mice, an animal model for human autoimmune T1D.
3- What combination therapies do you believe hold the most promise for T1Ds?
Based on my research findings refered to above, I was the principal investigator of a clinical trial (REPAIR-T1D) of the drug combination of sitagliptin and lansoprazole in patients with recent-onset T1D. Although this dual drug combination was not significantly effective in reversing T1D, the addition of a third drug, GABA, to sitagliptin and omeprazole has recently been found to prevent and reverse T1D in NOD mice, an animal model for human T1D.
4-Are there any molecules, vaccines, or approaches that you believe could be useful for the immune modulation piece of the T1D puzzle? (Presuming the beta cell regeneration piece is already addressed)
It is important to point out that the same triple drug combination of GABA, sitagliptin and omeprazole that regenerated beta cells and reversed autoimmune diabetes in NOD mice did so without the need for additional immunotherapy. This appears to be due to the dugs having immunotherapeutic as well as beta regenerative effects.
5-What is next for you? Any travel, leisure, or passion projects?
I am pleased to serve as a scientific consultant for Levicure as they develop a study protocol for a phase 2 clinical trial of the triple drug combination of GABA, sitagliptin and omeprazole in adult patients with recent-onset T1D.
THANK YOU for all of your work in this space!