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Target identification offers a promising approach for type 2 diabetes therapeutics
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Despite great strides in human genetic research, little is known about targets for prevention and treatment of type 2 diabetes, said David Altshuler, MD, PhD.
The hope is that identifying targets will improve success rates, according to Altshuler, director, Program in Medical and Population Genetics, Harvard Medical School.
“This is going to take 20 years,” he said. “The success rate is not going to jump from 5% to 100%. If it went from 5% to 10% that would actually have a profound impact.”
Still, the world of genetics is moving forward. Last year marked the discovery of novel, reproducible single nucleotide polymorphism associations in type 2 diabetes, hyperlipidemia, prostate cancer and rheumatoid arthritis and other common diseases. Presently, geneticists and researchers, including Altshuler, are studying these single nucleotide polymorphism associations to develop new targets for therapies and prevention. For example, drug targets PPARG and KCNJ11 for type 2 diabetes.
Now, there are 16 loci confirmed for type 2 diabetes; before 2006 there were just two, according to Altshuler. Prior to the focus on targets, human genetics studies were limited to family-based linkage studies and candidate gene association studies, but neither has been successful for type 2 diabetes.
“For the first time, we have methods giving us inherited contributors to human diseases. We should not ignore these clues,” he said. However, the debate remains about the typing of them immediately in populations.” – by Katie Kalvaitis
Gradually, as all of these findings come to light we are going to have to fast track drug development and tailor the drugs we prescribe for our patients with diabetes to the genetically determined type of diabetes they have. Diagnosis is going to have to change as well. The other thing we need to do, which may be difficult for treating physicians, is become aware that diabetes may not be categorized as just type 1 or type 2 anymore. This is only the beginning of what will develop during the next half decade, as an explosion or revolution in the field of diabetes occurs. We have to look out for these subtypes, be informed and on the cutting edge of what is going on in treating patients. My deepest hope is that we can accelerate targeted drug development to develop drugs that will be better for the patient – to help give them not only life but a more peaceful life without the ups and downs of the regimen that they are on now.
– Lee Ducat
President and Founder,
National Disease Research Interchange and Juvenile Diabetes Foundation
For more information:
Altshuler D. Genomic variation and the inherited basis of common disease. Presented at: Therapeutic Insights from New Diabetes Gene Discoveries. March 18-19, 2008; Philadelphia.