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MRI Assessment May Help to Define Pancreatic Inflammation Associated with Type 1 Diabetes

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mri Pancreatic InflammationA recent pilot study suggests that MRI assessment may be useful in defining pancreatic inflammation that is associated with type 1 diabetes.  The study, published in the Proceedings of the National Academy of Sciences and authored by researchers at the Joslin Diabetes Center, involved the use of coated iron nanoparticle approved by the FDA as an iron replacement therapy: ferumoxytol.  It is useful for this purpose because it leaks out of blood vessels when inflammation is present and then is taken up by the macrophages involved in the inflammatory process which is autoimmune in nature.  MRI assessment may provide additional information in addition to blood tests for autoantibodies which are now used to mark the possibility of disease.

As explained by Jason Gaglia, MD, MMSc, one of the investigators in the section of immunobiology at Joslin: “"Many people have genetic variants that put them at risk for type 1 diabetes", but there is, at present, no perfect marker for predicting whether someone will develop full-blown diabetes.  Another way in which MRI assessment may be useful is in following possible progression of inflammation to autoimmune disease.  Instead of years of measurements, Gaglia states that “you could have an answer in a matter of months.

This pilot study involved a limited number of subjects – 11 patients and 10 controls so will need to be repeated with larger numbers before the evidence can be considered reliable and valid, particularly since inflammation was observed to vary across the pancreas between and within individuals.  But the authors believe that this imaging technique utilizing Ferumoxytol-MRI could have a many applications in diabetes research and improve the understanding of the natural history of type 1 diabetes.  It may also have clinical applicability in screening certain individuals susceptible to disease.  
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