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Health
Towards a New Drug Class in the Treatment of Type 2 Diabetes
Type 2 diabetes is a major public health problem that affects millions of people worldwide. Developing new drugs to help better treat its underlying causes is therefore a research priority. In a new study coordinated by Inserm researcher Vincent Marion in collaboration with Monash University, the University of Birmingham (UK), and Alexander Fleming, former senior endocrinologist at the US Food and Drug Administration (FDA), the scientists have developed PATAS, a peptide that is part of a new class of antidiabetic drugs. PATAS can correct the metabolic abnormalities leading to type 2 diabetes and its associated comorbidities which include insulin resistance(1).
PATAS works by specifcally targeting the adipocytes (fat cells) (2), restoring glucose entry and thus correcting and re-establishing the metabolic physiology of the adipose tissue. The teams hope to set up a clinical trial soon to test this new therapy. Their study has been published in the journal Diabetes. Diabetes mellitus is a chronic condition that affects 537 million people worldwide, with the majority affected by type 2 diabetes. The prevalence of type 2 diabetes, which is characterized by high levels of glucose in the blood (see box), has been increasing for decades due to population aging, inactivity, and poor diet. The age of onset is also decreasing, and although the disease is considered to be an “adult disease”, it is now seen frequently in adolescents and children. Available drugs treat the consequences of type 2 diabetes by focusing mainly on lowering blood glucose; they do not target the underlying biological mechanism that causes the disease. Despite the urgency for developing new and more effective treatments, there have been no disruptive therapeutic innovations to reach market in over a decade. And this is precisely the objective of the research led by Inserm researcher Vincent Marion and his team at the Medical Genetics Laboratory (Inserm/ Université de Strasbourg). In a recent study
in collaboration with the University of Birmingham and Monash University, the scientists have developed a product called PATAS in a new class of diabetes drugs called “Adipeutics” (for therapies that specifcally target the adipocytes). Their study, conducted on animal models, shows that this new therapy specifcally restores glucose uptake in the adipocytes, resulting in the treatment of insulin resistance with benefcial effects on the whole body. This is made all the more promising by the fact that treating insulin resistance has the potential to address not only type 2 diabetes but a large array of serious medical conditions that result from this resistance.
Covid-19 reinfections add to the risk of acute complications and long Covid
Regular screening with very highly sensitive rapid antigen tests are a key factor in reducing transmission In the early days of the pandemic, it was rare to hear of people catching Covid twice. The Omicron variant that emerged in late November has changed that. As new variants have emerged, and immunity from previous infection and immunisation has reduced, reinfection with Covid-19 is becoming increasingly common. Some people have been infected four times in the past two years. A study published in March from the South African Centre for Epidemiological Modelling and Analysis found the risk of reinfection has “increased substantially”. This is supported by research from scientists at Imperial College, London that reports the chance of testing positive again is 5.4 times greater with Omicron than Delta. Andnow there are several omicron variants circulating around the world, all of which are highly transmissible and very good at overcoming immunity, whether it’s from vaccination, prior infection or both. These omicron variants don’t just evade the protection one may have gained from a non-omicron version of SARS-CoV-2; they make it possible to catch the newer variants of omicron even if the infected person has had the original omicron variant before. According to a report from July 8, the Australian Health Protection Principal Committee acknowledge that reinfections can occur as early as within 28 days and has adjusted the reinfection period from 12 weeks to 28 days. Of more concern however, is the theory thatreinfections may, in fact, be enhancing the disease, where a misfring immune response to the frst infection exacerbates the second. In dengue fever, for example, antibodies to an initial infection can help dengue viruses of another serotype enter cells, leading to a more severe and sometimes fatal second infection. And in other diseases, the frst infection triggers ineffective, non-neutralising antibodies and T cells, hampering a more effective response the second time around. Repeatedly catching Covid-19 appears to increase the chances that a person will face new and sometimes lasting health problems after their infection. Dr Ziyad AlAly, a clinical epidemiologist and chief of research and development at Veterans Affairs St. Louis Health Care System compared the health records of more than
250,000people who had tested positive for Covid-19 one time with records from 38,000 others who had two or more documented Covid-19 infections. More than 5.3 million people with no record of a Covid-19 infection were used as the control group. Among those with reinfections, 36,000 people had two Covid-19 infections, roughly 2,200 had caught Covid-19 three times and 246 had been infected four times. Common new diagnosis after reinfections included chest pain, abnormal heart rhythms, heart attacks, infammation of the heart muscle or the sac around the heart, heart failure and blood clots. Common lung issues included shortness of breath, low blood oxygen, lung disease and accumulation of fuid around the lungs. The study found that the risk of a new health problem was highest around the time of a Covid-19 reinfection, but that it also persisted for at least six months. The increased risk was present whether someone had been vaccinated or not, and it was graded – meaning it increased with each subsequent infection. Al-Aly said there is this idea that if you have had Covid before, your immune system is trained to recognise it and is more equipped to fght it, and if you’re getting it again, maybe it doesn’t affect you that much – but that just isn’t true. What this study shows is that each infection brings new risk, and that risk accumulates over time. Even when viruses shape shift – as infuenza does – our immune system generally retains its memory of how to recognise and fght off some part of them. They may still make us ill, but the idea is that our prior immunity is there to mount some kind of defence and keep us from serious harm. With coronaviruses, and especially SARS-Cov-2 coronaviruses, the hits just keep coming. Already there’s another omicron subvariant that has caught the attention of virologists: BA.2.75 was frst detected in India in early May. Since then, it’s been found in Europe, the United States, New Zealand and Australia. The chief scientist with the World Health Organisation (WHO), Soumya Swaminathan, has said that BA.2.75 appears to have mutated in a way that could indicate “major immune escape” but it’s too soon to know whether it will overtake BA.5 as the dominant variant. Graham Gordon, Founder and CEO of Gardian, an Australian-based MedTech company that has developed a robust, and verifable Covid screening program that effectively eliminates Covid ingress onsite said: “We understand pandemic fatigue, but the virus is not done with us. “Unfortunately, many people are viewing the pandemic as part of the fabric of modern life rather than an urgent health emergency. There is a signifcant resurgence, and we’re seeing increasing numbers of infections. Clearly this is a global concern.” Australia is nearing the numbers of Covid hospitalisations and daily deaths it saw during the January peak, but these are just the tip of the iceberg. As Covid hospitalisations increase, it strains other areas of the health system. And beyond the direct suffering of such a massive outbreak, there are likely to be economic disruptions as tens of thousands of people become too sick to work. “We are already being warned that a new batch of variants could come out of the blue,” said Gordon. “So, if you are at higher risk of serious illness or just want to avoid getting sick, it’s a good time to be wearing a N95 mask in public and using a rapid antigen test that has a low level of detection (LoD) so that you can detect infection prior to becoming infectious. “The same precautions used to prevent infection over the past two years are as relevant today as they have always been – wearing masks, social distancing, vaccinations, and a robust screening process are still necessary – and they work just as well for avoiding reinfection.”
