GRANTS. Anders Rosengren, a diabetes researcher at the Institute of Neuroscience and Physiology, is one of the recipients of the ERC Consolidator Grant for his research on type 2 diabetes. The European Research Council is providing him with SEK 20 million for his research, which can eventually result in more patients receiving customized treatment for their unique type of diabetes.
As a researcher at University of Gothenburg, Anders Rosengren participates in the Wallenberg Center for Molecular and Translational Medicine (WCMTM) initiative, where he works on identifying new treatments for type 2 diabetes. In his work as a physician, he can become frustrated over not yet knowing how the medications available on the diabetes market are to be used in individual cases.
“All guidelines talk about how treatments should be adapted to the individual, but there is no systematic basis for this, so the process often can be likened to trial and error. I want to try to remedy that,” says Rosengren.
According to the World Health Organization, type 2 diabetes is the world’s fastest growing disease at present, and more than 350 million people suffer from it.
“Cancer research, for example, has come farther in terms of tailored treatments, but this is more difficult with cardiovascular disease and diabetes because they involve many interacting genes and lifestyle plays a central role,” says Rosengren.
Testing two medications
In a clinical study, the research team will test two types of medications already on the market. They will be tested on 200 people who belong to two different groups within type 2 diabetes. The groups are divided according to low and high insulin production and insulin sensitivity. The drugs, SGLT2 inhibitors and GLP1, have previously been shown to have cardiovascular benefits, and Rosengren’s research team wants to investigate if they work better for some patients than others.
“There is a surprisingly large variation of disease characteristics among patients, and the idea is to try to adapt the medicine to each person,” says Rosengren.
Even if researchers find no difference in the effect of medications between the groups, knowing that would also have practical importance.
“This is actually the first systematic test of personalized medicine for diabetes, which has been talked about for several years, even in official guidelines, but has never been put up for testing. It will be very exciting to conduct this study based on two groups of diabetic patients. If it works, it opens up entirely new possibilities for specific treatment, but even if we fail to find the right medication, it also provides an answer. In that case, we need even more precise medications in the future or completely different treatment strategies,” he says.
Passive beta cells
The fact that insulin production decreases over time is something that all patients with type 2 diabetes will eventually suffer, but it has been difficult to pinpoint the underlying mechanisms. Recently Anders Rosengren’s research team has identified two genes, SOX5 and ADRA2A, and altering expression of them makes the beta cells passive, halting or diminishing insulin production. Working with Patrik Rorsman, a research colleague at the Department of Metabolic Physiology at Sahlgrenska Academy, Rosengren has developed methods to look at how much insulin each cell releases.
“Based on this, we want to map the gene expression at the single cell level and find the genes driving beta cell failure,” says Rosengren.
Another objective of the research is finding a medication that can help solve the fundamental problem of failing beta cells.
Gothenburg resident for three years
Anders Rosengren came to Gothenburg from Lund three years ago and has since built up his research team in Gothenburg. He has already attracted several large research grants to his team, most recently from the European Research Council. He had already become interested in research during medical training, and he took his doctorate after completing his medical training. His dissertation dealt with basic cellular physiological mechanisms in type 2 diabetes, and after defending his thesis and doing his internship, he did postdoctoral research in Seattle, where he learned to work with bioinformatic methods. Being able to work translationally with ongoing research has become an important factor in obtaining results that are relevant to patients, he believes.
“Among other things, we can recruit patients and can choose among a base of 19,000 well-characterized type 2 diabetes patients for our first study, which starts in the spring of 2020 and will last for one year. We will be starting our studies at the single-cell level in parallel with this,” Rosengren explains.
From cell studies to clinical trials
The ERC Consolidator Grant is very valuable because it enables the team members to develop their research over a five-year period, providing stability for the future. Rosengren found preparing for the application both enjoyable and challenging.
“There is always a certain amount of gambling involved when applying for grants, because you do not know if the effort will pay off. At the same time, the application made me think through all the research in detail, which was valuable. When I learned that we received the grant, it of course felt really great that it worked out well,” says Rosengren.
With partners such as Anders Ståhlberg, Fredrik Bäckhed and Patrik Rorsman, Anders Rosengren and his research team will develop their measurement methods and research questions to try to bring the mystery of diabetes one step closer to an answer.
“It is very inspiring to engage in this type of research, where you can be involved all the way, from cell studies to clinical trials, and I hope that many people who suffer from the disease can benefit later. In any case, that is the ultimate goal,” says Rosengren.
TEXT: JESSIKA DEVERT / FREELANCE JOURNALIST
PHOTO: JOHAN WINGBORG
