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BCG vaccine leads to long-term improvement in blood sugar levels in type 1 diabetes patients

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  1. patience_limited
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    Original paper here: https://www.nature.com/articles/s41541-018-0062-8 There are several remarkable things about this study (the tl;dr is that a reset switch for autoimmunity may have been...

    Original paper here: https://www.nature.com/articles/s41541-018-0062-8

    There are several remarkable things about this study (the tl;dr is that a reset switch for autoimmunity may have been discovered, as well as an effective method for changing epigenetic markers):

    1. It reveals a novel mechanism for treating an autoimmune disease (induction of TNF to reduce white blood cell types that attack normal tissue), which may be applicable to diseases other than Type 1 diabetes (e.g. multiple sclerosis);
    2. It reveals another novel effect of BCG vaccine in modifying epigenetic markers, both in T-cells, and general cellular glycolysis pathways, from normal oxidative phosphorylation to aerobic glycolysis (more glucose consumption without additional insulin, an effect which means it may help treat Type II diabetes as well);
    3. The treatment appears to be effective in reducing HbA1c to near normal levels regardless of how long or how severely the patients have been affected;
    4. The effect persisted and increased through a lengthy followup period (8 years), showing that the effect of the treatment may be life-long;
    5. It uses only intermittent doses of the inexpensive existing BCG vaccine, which has had a fantastic safety record through over a century of use;
      6) The trials are publicly funded, without industry support.

    The bad news is, even though glycosylated hemoglobin decreases, there's no evidence that destroyed pancreatic islet cells regenerate.

    This study uses a surrogate measure (HbA1c), not insulin usage, but there's a Phase II study underway to determine whether this is a functional "cure". Even if it just reduces need for exogenous insulin, the vaccine treatment could improve the lives of millions of Type 1 diabetics, who are constantly balancing between long-term damage from hyperglycemia, and short-term life-threatening hypoglycemic attacks.

    Be sure to read the FAQ.

    If the proposed mechanism is valid, expect it to be coming for a wide range of diseases related to autoimmunity - multiple sclerosis, rheumatoid arthritis, etc.

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