Diabetes Type 1 near-cure found through CNS connection?  Perhaps Crohn's and
asthma have similar connections?

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http://www.canada.com/topics/bodyandhealth/story.html?id=fdd3aeb6-319c-4deb-9e21
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TORONTO - Scientists at a Toronto hospital say they have proof the body's
nervous system helps trigger diabetes, opening the door to a potential
near-cure of the disease affecting millions of Canadians.

Diabetic mice became healthy virtually overnight after researchers injected
a substance to counteract the effect of malfunctioning pain neurons in the
pancreas.

The researchers caution they've yet to confirm their findings in humans, but
say they expect results from those studies within a year or so.

Any actual treatment that may emerge from the work is likely still years
away.

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Their conclusions upset conventional wisdom that Type 1 diabetes, the most
serious form of the illness that typically first appears in childhood, was
solely caused by auto-immune responses _ the body's immune system turning on
itself.

They also conclude that there are far more similarities than previously
thought between Type 1 and Type 2 diabetes, and that nerves likely play a
role in other chronic inflammatory conditions, such as asthma and Crohn's
disease.

The ``paradigm changing'' study opens ``a novel, exciting door to address
one of the diseases with large societal impact,'' said Dr. Christian
Stohler, a leading U.S. pain specialist and dean of dentistry at the
University of Maryland, who has reviewed the work.

``The treatment and diagnosis of neuropathic diseases is poised to take a
dramatic leap forward because of the impressive research.''

About two million Canadians suffer from diabetes, 10 per cent of them with
Type 1, contributing to 41,000 deaths a year. Insulin replacement therapy is
the only treatment for Type 1, and can't prevent many of the side-effects,
from heart attacks to kidney failure.

In Type 1 diabetes, the pancreas doesn't produce enough insulin to shift
glucose into the cells that need it. In Type 2 diabetes, the insulin
produced isn't used effectively _ something called insulin resistance _ also
resulting in poor absorption of glucose.

The problems stem partly from inflammation _ and eventual death _ of
insulin-producing islet cells in the pancreas.

Dr. Hans Michael Dosch, an immunologist at the hospital and a leader of the
studies, had concluded in a 1999 paper there were surprising similarities
between diabetes and multiple sclerosis, a central nervous system disease.

His interest was also piqued by the presence around the insulin-producing
islets of an ``enormous'' number of nerves, pain neurons primarily used to
signal the brain that tissue has been damaged.

Suspecting a link between the nerves and diabetes, he and Dr. Michael
Salter, a pain expert at the Hospital for Sick Children, used an old
experimental trick _ injecting capsaicin, the active ingredient in hot chili
peppers, to kill the pancreatic sensory nerves in mice which had an
equivalent of Type 1 diabetes.

``Then we had the biggest shock of our lives,'' said Dr. Dosch. Almost
immediately, the islets began producing insulin normally ``It was a shock
Ereally out of left field, because nothing in the literature was saying
anything about this.''

It turns out the nerves secrete neuropeptides that are instrumental in the
proper functioning of the islets. Further study by the team, which also
involved the University of Calgary and the Jackson Laboratory in Maine,
found the nerves in diabetic mice were releasing too little of the
neuropeptides, resulting in a ``vicious cycle'' of stress on the islets.

The work is being published today in the journal Cell.

National Post

tblackwell@nationalpost.com