Islet biology

Our research is focused on preventing pancreatic beta cell destruction to preserve beta cell mass in diabetes. We have identified pathways of beta cell death in type 1 and 2 diabetes. We aim to understand how different effector mechanisms participate in diabetes development, and how they can be prevented. The pathogenesis of type 1 and 2 diabetes is complex, with immune abnormalities in type 1 and insulin resistance in type 2 diabetes. However, beta cell deficiencies are required for both diseases, and this is the focus of the Islet Biology Laboratory. In type 1 diabetes, we study the interaction between the immune system and beta cells. In particular, we are interested in preventing beta cell killing by CD8+ T cells, and in understanding the mechanisms by which CD4+ T cells kill beta cells. We are studying the stress, inflammatory and cell death pathways activated by high glucose concentrations in beta cells in type 2 diabetes, and we are testing the role of these pathways in vivo. Our work is being applied to humans through the transplantation of human islets from organ donors to reverse diabetes in severe cases.

Research Themes

Re-purposing drugs for use in type 1 diabetes clinical and pre-clinical studies

Group Leader: A/Prof Helen Thomas
Team Members: Dr Prerak Trivedi, Dr Robyn Sutherland, Dr Michaela Waibel, Dr Stuart Mannering, Mr Nick Scott, Ms Victoria Huang, Ms Stacey Fynch, Prof Tom Kay
Collaborators: Dr Chris Burns, Prof Bruce Kemp, Dr Misty Jenkins, Prof Matthias von Herrath

Discovering new applications for approved drugs or those in advanced clinical development is one way to ensure a rapid transition from the laboratory to the clinic. For many of the pathways involved in diabetes pathogenesis, drugs already exist that have been developed for other applications, such as cancer therapy. We have established a pipeline of pre-clinical studies with such drugs, and plan to progress these through to clinical studies in type 1 diabetes. These drugs may also be used together with antigen-specific immunotherapy. We hope to identify regimens that are effective but safe, and which do not have to be administered lifelong. We have tested inhibitors of JAK1/JAK2, the kinases downstream of many cytokine receptors. Our data indicate that JAK inhibitors prevent the migration of immune cells into islets, prevent diabetes in mouse models, and reverse established autoimmune diabetes in non-obese diabetic (NOD) mice. There are many other kinase inhibitors being developed for other indications. We will test these in NOD mice, in collaboration with leaders in kinase biology and pharmaceutical companies.

Activation of innate immunity and type 1 interferon production in initiation of type 1 diabetes

Group Leader: Dr Helen Thomas
Team Members: Dr Satoru Akazawa, Dr Zia Mollah, Mr Evan Pappas, Ms Leanne Mackin, Mr Justin Kwong, Prof Tom Kay
Collaborators: Prof Joe Trapani, Prof Phil Bird, Dr Tom Brodnicki, Dr Bala Krishnamurthy

The trigger leading to loss of tolerance to self-antigens in genetically predisposed individuals is conventionally thought to follow an environmental event such as viral infection. We have identified an endogenous trigger that can activate the very small number of T cells that recognise islet autoantigens. Granzyme A is a protease implicated in the degradation of intracellular DNA, and we have identified an important role for granzyme A in regulating autoimmunity. Absence of granzyme A accelerates diabetes in NOD mice and results in increased cytosolic DNA that can act as an endogenous signal to stimulate local type I IFN production. This activates the residual autoantigen-specific T cells that have escaped thymic deletion, even in immune tolerant individuals. We will study NOD mouse models and samples from patients with pre-diabetes and established diabetes to understand how granzyme A maintains immune tolerance. These studies will likely lead to a paradigm shift in understanding the triggers of type 1 diabetes, which are currently very poorly understood.

Intracellular pathways of beta-cell death in type 2 diabetes

Group Leader: A/Prof Helen Thomas
Team Members: Dr Jingjing Ge, Mr William Stanley, Dr Sara Litwak
Collaborators:  Prof Andreas Strasser, Dr Sean McGee, Dr Ian Smyth

Type 2 diabetes is an enormous global health problem affecting nearly 350 million individuals world-wide. It occurs as a result of declining beta-cell function in insulin-resistant subjects together with a decrease in beta cell mass. Evidence suggests that loss of beta cell mass is due to apoptosis, with hyperglycaemia as a potential cause. Inhibition of apoptosis may be able to prevent beta cell loss. Increasing functional beta cell mass would reduce insulin requirements, improve glucose control and reduce complications of diabetes. However, drugs to inhibit apoptosis have not been implemented in diabetes.

Using very well characterized mouse models, we were the first to identify that the pro-apoptotic molecules BIM and PUMA are required for glucose-induced apoptosis of islet cells. We have generated exciting results that suggest BIM deficiency protects leptin receptor mutant mice from development of fasting hyperglycaemia and increases beta cell mass. It is unclear whether this is an intrinsic beta cell effect or due to improved insulin sensitivity. We aim to study how BIM contributes to type 2 diabetes development using conditionally targeted mouse models. We will also examine how beta cell mass is increased in BIM-deficient mice.

Honours and PhD Projects


  • A/Prof Helen Thomas
  • Stacey Fynch
  • Sara Litwak
  • Jingjing Ge
  • Dr Prerak Trivedi
  • William Stanley
  • Evan Pappas
  • Dr Michaela Waibel
  • Justin Kwong
  • Megan Smith
  • Dr Satoru Akazawa
  • Tara Catterall

Publication Highlights

  1. Thomas HE, Parker JL, Schreiber RD, Kay TWH. IFN- action on pancreatic beta cells causes class I MHC upregulation but not diabetes. J. Clin. Invest. 102:1249-1257 (1998)
  2. Chong MM, Chen Y, Darwiche R, Dudek NL, Irawaty W, Santamaria P, Allison J, Kay TW, Thomas HE. Suppressor of cytokine signaling-1 overexpression protects pancreatic cells from CD8+ T cell-mediated autoimmune destruction. J. Immunol, 172:5714-5721 (2004)
  3. Thomas HE, McKenzie MD, Angstetra E, Campbell PD, Kay TW. Beta cell apoptosis in diabetes. Apoptosis 14:1389-1404 (2009)
  4. O’Connell PJ, Holmes-Walker JD, Goodman D, Hawthorne WJ, Loudovaris T, Gunton JE, Thomas HE, Grey ST, Drogemuller CJ, Ward GM, Torpy DJ, Coates PT, Kay TW, On behalf of the Australian Islet Transplant Consortium. Multicenter Australian Trial of Islet Transplantation: Improving Accessibility and Outcomes. Am. J. Transplant., 13:1850-8 (2013)
  5. Quah HS, Miranda-Hernandez S, Khoo A, Harding A, Fynch S, Elkerbout L, Brodnicki TC, Baxter AG, Kay TWH, Thomas HE*, Graham KL* Deficiency in type I interferon signaling prevents the early interferon-gene signature in pancreatic islets but not type 1 diabetes in non-obese diabetic mice. Diabetes 63:1032-40 (2014)
  6. Wali JA, Rondas D, McKenzie MD, Zhao Y, Elkerbout L, Fynch S, Gurzov EN, Akira S, Mathieu C, Kay TW, Overbergh L, Strasser A, Thomas HE The pro-apoptotic BH3-only proteins Bim and Puma are downstream of endoplasmic reticulum and mitochondrial oxidative stress in pancreatic islets in response to glucotoxicity. Cell Death Dis. 5:e1124 (2014)
  7. Zhao Y, Scott NA, Fynch S, Elkerbout L, Wong WW-L, Mason KD, Strasser A, Huang DC, Kay TWH, Thomas HE Autoreactive T cells induce necrosis and not BCL-2-regulated or death receptor-mediated apoptosis or RIPK3-dependent necroptosis of transplanted islets in a mouse model of type 1 diabetes. Diabetologia 58:140-8 (2015)
  8. Trivedi PM, Graham KL, Scott NA, Jenkins MR, Majaw S, Sutherland RM, Fynch S, Lew AM, Burns CJ, Krishnamurthy B, Brodnicki TC, Mannering SI, Kay TW, Thomas HE. Repurposed JAK1/JAK2 inhibitor reverses established autoimmune insulitis in non-obese diabetic mice. Diabetes 66:1650-60 (2017)
  9. Mollah, ZU, Quah HS, Graham KL, Jhala G, Krishnamurthy B, Francisca M Dharma J, Chee J, Trivedi PM, Pappas EG, Mackin L, Chu EP, Akazawa S, Fynch S, Hodson C, Deans AJ, Trapani JA, Chong MM, Bird PI, Brodnicki TC, Thomas HE, Kay TW. Granzyme A-deficiency breaks immune tolerance and promotes autoimmune diabetes through a type I interferon-dependent pathway. Diabetes, in press (2017)