Tuberculosis Vaccine Could Reverse Type 1 Diabetes.

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Tuberculosis Vaccine Could Reverse Type 1 Diabetes, Study Shows.

The causes of Type 1 diabetes can be significantly reversed over several years with just two injections of a common tuberculosis vaccine injected a few weeks apart, researchers at Massachusetts General Hospital (MGH) announced Thursday in a paper published in the journal Nature.

Researchers found a substantial reduction in the blood-sugar marker HbA1c that is used to diagnose diabetes. All subjects with diabetes who received the vaccine had a 10% reduction after three years and 18% after four years, bringing them below the cutoff point for a clinical diagnosis. Those subjects followed for a full eight years retained most of the reduction.

Participants who received a placebo or were in a reference group that followed normal diabetic management saw their blood sugar measurement rise by a few percentage points during the same periods followed. Subjects of the study receiving the vaccine or placebo continued to use insulin during the study period.

The study’s principal director, Dr. Denise Faustman, director of the MGH Immunobiology Laboratory, told FierceBiotech and other news outlets, “Nobody thought you could intervene with an immunotherapy in people 10, 20 years out. To have data showing durability for 8 years, without revaccination, is remarkable.”

A 10% reduction in Hb1Ac reduces the risk of death as a result of diabetes by 21%, and drops by 37% other complications, like blindness and loss of feeling in hands and feet, according to a 2000 study.

The study followed a relatively small number of people: 52 total with Type 1 diabetes, only 12 of whom received injections. Of the 12, nine received the vaccine and three the placebo. All 52 had follow-up measurements through five years. And three of those who received the vaccine were followed for eight years.

Medical researchers not involved in the study expressed a range of high to very mild skepticism about the validity of the study due almost entirely to its small size. “This could be something that happened by chance because people were a bit more diligent or leaner or more compliant with diet,” Dr. Adrian Vella, an endocrinologist at the Mayo Clinic, said in an interview with NBC News. However, Dr. Joseph Bellanti, a professor of pediatrics and microbiology-immunology at Georgetown Medical Center, said in an interview with WBUR that was “cautiously optimistic” because of the quality of the study’s design.

A failure to produce enough insulin, Type 1 diabetes affects an estimated 20 to 40 million people globally. The more common form Type 2, resulting from obesity and lack of exercise, affects at least 400 million people. Diabetes incidence has more than quadrupled in the last 40 years.

The study relied on the bacillus Calmette-Guérin (BCG) vaccine, which has been used in humans since 1921. Its use is limited in the United States, because the form of bacteria it protects against, Mycobacterium tuberculosis, is rare in this country. The CDC generally recommends against its use as it creates false positives from a TB test that’s routine in the U.S. However, it’s been administered to an estimated 4 billion people.

Based on initial mice tests, researchers expected the vaccine would prompt regeneration of the pancreas, which produces insulin. Instead, they write in their paper, a form of white blood cells starts to metabolize sugar more aggressively—10 to 20 times as much as they normally consume.

However, the long delay in a measurable effect wasn’t a surprise. A number of studies using BCG that have produced outcomes such as slowing the progress of multiple sclerosis and other autoimmune diseases show a long onset.


A Jury May Have Sentenced a Man to Death Because He’s Gay. And the Justices Don’t Care.

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On Monday, the Supreme Court announced it would not stop South Dakota from killing a man who may have been sentenced to death because he is gay.

Some of the jurors who imposed the death penalty on Charles Rhines, who was convicted of murder, have said they thought the alternative — a life sentence served in a men’s prison — was something he would enjoy as a gay man.

During deliberations, the jury had often discussed the fact that Mr. Rhines was gay and there was “a lot of disgust” about it, one juror recalled in an interview, according to the court petition. Another said that jurors knew he was gay and “thought that he shouldn’t be able to spend his life with men in prison.” A third recounted hearing that if the jury did not sentence Mr. Rhines to death, “if he’s gay, we’d be sending him where he wants to go.”

The justices rejected Mr. Rhines’s plea to hear his bias claim, allowing his death sentence to stand despite disturbing evidence that it may have been the result of anti-L.G.B.T. animus. As usual, the court gave no explanation for its decision not to review the case. But its silence sent a deeply troubling message about the value placed on the lives of L.G.B.T. people.

In court papers opposing Mr. Rhines’s request for a fair sentence, South Dakota attempts to brush off this last remark as a “stab at humor” that didn’t land well. But a note from the jury to the sentencing judge leaves little doubt that this extraordinary assumption infected the jury’s decision-making process: “We know what the death penalty means. But we have no clue as to the reality of life without parole.”

In that note, the jurors went on to ask a series of questions aimed at whether Mr. Rhines would be in proximity to other men in prison. Would he “be allowed to mix with the general inmate population?” Would he be permitted “to discuss, describe or brag about his crime to other inmates?” Would he “have a cellmate?”

In other words, some members of the jury thought life in prison without parole would be fun for Mr. Rhines. So they decided to sentence him to death.

Juror deliberations are considered sacrosanct, but last year the Supreme Court carved out an important exception for cases of racial bias in the jury room. In a race discrimination case, there was evidence that the jury decided to convict an accused man of unlawful sexual contact and harassment because “he’s Mexican, and Mexican men take whatever they want,” in the words of one juror. The Supreme Court rightly found that such racial animus interfered with an accused’s person right to a fair and impartial trial.

The same rule should apply when anti-L.G.B.T. prejudice taints juror decision-making. To be sure, the history of racism in America is unique and demands unique safeguards. But that does not make anti-L.G.B.T. discrimination any less objectionable, particularly when it may have made the difference between life and death.

It’s difficult to square allowing the state to execute Mr. Rhines because of his sexual orientation with the Supreme Court’s observation this month that states should prevent the harms of discrimination against L.G.B.T. people. And while bias in the criminal justice system is not always explicit, it was in Mr. Rhines’s case. That makes the court’s decision not to step in even more alarming.

Sadly, the court will almost certainly be presented with more requests to review convictions or sentences poisoned by anti-L.G.B.T. bias. It should take the next opportunity to correct this mistake and recognize that prejudice against people who are L.G.B.T. should play no role in America’s criminal justice system.

However, that will probably come too late for Mr. Rhines.

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