2005 - Injection for diabetic nerve pain
Patients are to test a trial treatment for diabetic nerve damage after promising studies on animals.
The monthly injection works by stimulating the body to make a natural protein that prevents nerve damage caused by the disease.
The University of Manchester team say a neuropathy treatment is much needed, particularly as 366 million people are expected to have diabetes by 2030.
The patient trials will begin in Texas, run by US company Sangamo BioSciences.
Nerve damage
Diabetic neuropathy affects around 50% of people who have had diabetes for 15-20 years, and is related to poor blood-sugar control.
The first symptom the person may notice is tingling or pins and needles, which can progress to intense pain.
Currently, there are no effective therapies available to treat this disabling and frequent complication of diabetes
Dr Mark Kipnes, clinical investigator for Sangamo
They may also get numbness and can hurt themselves because they can no longer detect things that can cause harm, such as hot water or tight shoes.
This can mean damage goes undetected and, in extreme cases, amputation of the injured limb or digit may be necessary.
A naturally occurring protein called vascular endothelial growth factor or VEGF has been shown to have direct protective properties on nerves in lab experiments.
This prompted Professor David Tomlinson and colleagues at the University of Manchester to look at whether harnessing VEGF could be a good way to treat diabetic neuropathy.
Animal work
Rather than injecting extra VEGF into the body, which Professor Tomlinson said could potentially cause side effects, he decided to see if he could make animals produce more of their own VEGF in the areas where they needed it.
The agent they used in the animals is a gene that increases the production of VEGF.
We will await the results of the human trials with interest
Natasha Ede, care advisor for Diabetes UK
"The gene will only be expressed in cells that are designed to express it - the proper place - so it's targeted."
He said the treatment appeared to work in the animals with no obvious side effects.
His team plans to carry out more work to determine where exactly in the body the gene is active - in the muscles or the nerves themselves.
The US team are pushing ahead with the first phase of human trials and envisage that one injection of the drug every month should be enough to treat diabetic neuropathy.
Dr Mark Kipnes, clinical investigator for Sangamo, said: "Currently, there are no effective therapies available to treat this disabling and frequent complication of diabetes and patients are generally prescribed painkillers to alleviate symptoms.
"We are excited to be involved in testing this novel approach that may potentially have a dramatic therapeutic effect in populations of patients already suffering from neuropathy and those who are at risk of developing it."
Natasha Ede, care advisor for Diabetes UK, said: "This research is certainly promising but it is still in the very early stages.
"Unfortunately there is currently no cure for neuropathy but good blood glucose and blood pressure control and a healthy lifestyle reduce the risk of it developing.
"We will await the results of the human trials with interest."
Annwen Jones, of the Juvenile Diabetes Research Foundation, said: "It is a positive step forward and, if found to be effective, could prevent millions of people from developing this serious and painful complication of Type 1 diabetes.
"It is critical that research continues to develop new therapies for treating and ultimately curing Type 1 diabetes."
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