Diabetes Week : Nikita’s Story
During Diabetes Week we will be posting up a series of blogs all about research. Nikita is a PHD student who has written about the research she does and what it means to her. Nikita is just one person in an army of diabetes researchers who are aiming to improve the lives of people with diabetes everywhere and one day, soon hopefully, find a cure.
Over to Nikita to explain about the future of her research and the difference it could make.
What made you get into diabetes research?
Since I was a child, I’ve known many of my family members to be diagnosed with diabetes, so my interest in diabetes initially started off as a curiosity, and the more I learned about it, the more fascinated I became. During my neuroscience degree at the University of Bristol, I learned more about how and why diabetes can occur, which only fuelled my interest further. After my degree, I came across this PhD position, which combines my love of neuroscience research and my fascination with diabetes together, in a very unique way. As diabetes is becoming much more prevalent, I liked the idea of working in a field that is very relevant to myself and to many people, which makes me feel very motivated. Diabetic retinopathy is the leading cause of blindness in the western world, affecting both type 1 and type 2 diabetics, and so is an important area of research. This is an exciting project to be working on,as it is not only a novel idea, but is also very translational.
What’s your day to day involvement in the research?
Most days in the lab, I’m conducting experiments looking at cells and imitating a “diabetic” environment for them, and seeing how they respond, and whether I can influence this for the better. There is a lot of molecular biology involved in my project, and so I’m often looking at DNA and how I can modify it to express particular genes of interest, and then seeing if I can make cells and rats express this too. I am very fortunate to be working in a lab that is so multidisciplinary, as there are many people working on the impact of diabetes for example in terms of kidney disease and diabetic pain, and so this broadens my knowledge of diabetes and how it can affect many different people. It also means that I am surrounded by a wealth of knowledge and expertise in many different areas, which is always a bonus if I’m having difficulties.
What are the ultimate aims of your research?
A common consequence of type 1 and type 2 diabetes is suffering from vision deficit, from a partial loss to blindness. Diabetic blindness, also known as diabetic retinopathy (DR): stems from the characteristic increased blood-sugar level, resulting in the eye being deprived of oxygen. This triggers the production of a protein, vascular endothelial growth factor (VEGF-A) that stimulates new blood vessel growth in the eye, so that more oxygen can reach any deprived areas. However, these blood vessels are prone to breakage and can leak fluid into the eye. In many cases, the blood vessels can grow through the back of eye and again impair vision and cause nerve damage. An alternative type of VEGF-A, VEGF165b, was discovered to the ability to protect blood vessels and nerves. Furthermore, this particular type of protein is produced in a healthy eye, but is decreased in a diabetic eye.
Drugs that block VEGF have shown to improve vision in patients with diabetic macular oedema, also a type of diabetic vision loss, but show little evidence of exerting a protective effect against nerve damage in the eye. Previous work has shown that VEGF165b can decrease the amount of new blood vessel growth in the eye and can protect against diabetic nerve damage in the skin. Current therapies involve multiple injections to the eye, which can be unpleasant. My project hopes to achieve a novel treatment where the patient only requires one injection of viral VEGF165b, in the hope that it will stimulate cells of the diabetic eye to then produce the same protein themselves, thus improving vision. We aim to determine the therapeutic potential of VEGF165b by testing it on cells found in the eye and then on diabetic rats. We will achieve this by developing a virus and engineer it such that when injected into the eye, it will trigger the cells to make their own VEGF165b, and heal itself in terms of strengthened blood vessels and decreased breakdown of nerve cells.
Gene therapy is an exciting area of research, which has recently entered clinical trials, aiming to treat many conditions including heart failure and some forms of inherited blindness. It is a potentially very useful therapeutic tool as one can manipulate DNA to, for example, over express a particular gene that is deficient or malfunctioning in a diseased state. This is then incorporated into a virus, and then injected into a subject with the condition of interest, for example, diabetes. The beauty of this new method is that once the virus is in the subject, it then “infects” the host and then encourages other cells to express the genes that it possesses, without much further interference, allowing the body to heal itself. By targeting specific genes involved with the condition, it allows the treatment to become more tailor-made to the disease in question. This is exciting as it means that once you’ve manipulated the genes of the host, if it works, then the host may not require any further treatments therefore greatly reducing treatment associated side-effects, as seen with repeated dose therapies.
What hopes do you have for your research and your career?
I would be thrilled if the treatment worked, and we were indeed able to treat diabetic blindness in rats, as it would be a plausible treatment for humans. This would also be a good As I’m currently half way through my PhD, I’m not quite sure what the future holds but I know that I would like to stay in diabetes research.