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Watching Diabetes in Reverse – Only at UCSF?

EUpdate, published by the scientists and staff of the Diabetes Center at UCSF

In the diabetes research community, the race, as they say, is on! Researchers around the world are using new, state-of-the-art technologies in their attempts to find the genetic and cellular signatures of people who are destined to develop type 1 diabetes. These signatures would form the basis of new, more sensitive diagnostic tests that would allow very early intervention – and possibly the prevention – of diabetes.

Dr. Karen Earle

In the thick of this race is Diabetes Center fellow Dr. Karen Earle, MD. Her research first aims to find the changes that take place in the T cells of “new onset” patients, those that have just been diagnosed and whose disease is in its earliest stages. T cells are the white blood cells that lead the immune system’s attack on the pancreatic beta cells, depriving the body of its insulin-producing abilities.

Like many researchers around the world, Dr. Earle is looking to find differences in gene expression and other characteristics of these cells between normal, healthy individuals, patients who have “new onset” diabetes (ones that have just been diagnosed) and patients with established diabetes.

“We expect to find many differences between healthy individuals and diabetes patients,” says Dr. Earle. “The trick is to find out which of the changes we detect are the ones that are responsible for the development and progression of diabetes and which ones are the result of treatments or other associated changes in metabolism.”

This, according to Dr. Earle, is where UCSF has the upper hand.

“We are in a very unique position here at UCSF,” says Dr. Earle. “The Center’s success with OKT3gamma(Ala-Ala) means that we are one of the only research facilities in the world that can watch diabetes in reverse.”

Working closely with Dr. Steve Gitelman and Dr. Jeffrey Bluestone, the JDRF-funded fellow will apply her battery of genetic and cellular tests to T cells from patients whose diabetes has been effectively halted using UCSF’s headline-making OKT3gamma(Ala-Ala). With this unique group of patients folded in the mix, Dr. Earle will be able to track the changes that occur in T cells as diabetes develops – and, as it is reversed.

“The ability to examine patients in which the autoimmune attack has effectively been halted is very exciting. It adds another level to the investigation, where we can really get to the heart of which factors are critical in the development of diabetes,” she says.

The identification of these critical changes would be the first step in developing a new diagnostic marker for diabetes. In turn, this information would ultimately be used to identify diabetes patients very early in the course of the disease, or provide a more accurate assessment of an individual’s risk of developing the disease in their lifetime.

Dr. Earle received her medical training at Yale Medical School prior to joining UCSF five years ago. She is currently a clinical fellow in endocrinology and immunology, meaning she feels at home in both the laboratory and the clinic. Dr. Earle regularly sees patients in both the Adult and Pediatric Diabetes Clinics.