Researchers from Haukeland University Hospital and the University of Bergen published an article in Nature Genetics, one of the highest ranked journals in the field of biomedicine. The article describes two families where doctors have diagnosed an unusually high incidence of diabetes among family members.

The pancreas has two distinct and maybe inter-related functions; the production and secretion of enzymes involved in digestion in the intestine (pancreatic juice) and the production of hormones including insulin, which is involved in the control of blood sugar levels. Problems with the enzyme-producing function of the pancreas are observed in diabetic patients, but the relationship between the different pancreatic functions, the contributing genetic factors and the disease are as yet poorly understood.

The discovery of a new form of diabetes stemmed from the closer study of the family members. This revealed that those family members with diabetes also had disrupted function of the pancreas' digestive enzyme production; in particular the production of carboxyl ester lipase, which is a major component of pancreatic juice. The researchers undertook genetic studies and showed that the dysfunction was due to mutations of the gene that encodes for this particular pancreatic enzyme.

In their conclusions, the researchers underlined that carboxyl ester lipase exists in many different forms and that future investigations of patients with diabetes should also study the presence of these variants.

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In this study, Jefferies and his colleagues vaccinated mice against the viral relatives of rabies and measles viruses and simultaneously induced the overproduction of one component already part of the immune system, called TAP, which enhances MHC activity. Subsequently, specific destroyer cells increased fourfold, compared with traditional vaccination. Since these cells help initiate immunity, the group recognized that they were an important piece of the puzzle, according to Jefferies. The pathway works like a machine or factory where increasing the efficiency of one component part can lead to a massive increase in functional output, he said.

Next, using varying doses, the team vaccinated mice against a relative of the smallpox virus. Mice immunized with just one-hundredth the standard dose and induced to overproduce TAP were still able to survive an otherwise lethal viral infection.

We were surprised that over-expression of TAP would have such a great effect because it implies that it is in limiting amounts normally or is inefficient normally, Jefferies said. Combining viral antigens with a gene that is involved in their processing appears to be a solution to increasing the efficacy of vaccines in general.

dx.doi/10.1371/journal.ppat.0010036

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