Meet our doctors: Bart O. Roep on the future of diabetes research

February 22, 2016 | by City of Hope

From his earliest days as a medical student, Bart O. Roep, PhD., had a goal – to find a cure for type 1 diabetes. Over the last 25 years, his quest has earned him numerous medical and scientific awards. Now, as the founding chair of the Department of Diabetes Immunology, located within the Diabetes & Metabolism Research Institute at City of Hope, Roep says he is excited to be working with like-minded partners to make this ambitious goal a reality.

Here, we speak with the renowned immunologist about his background and vision for the future of diabetes research and treatment.

1. What inspired you to enter the field of diabetes research?  

As medical student, I was quite disappointed to be taught that type 1 diabetes was incurable. With insulin replacement therapy, we were left treating the symptoms, but not the cause of the disease. That was when I turned to medical research. 

After a short spell at the Netherlands Cancer Institute in Amsterdam, I moved to the Leiden University Medical Center (LUMC) to learn more about clinical immunology and immunogenetics. The LUMC is famous for several discoveries, including that of the human leukocyte antigen (HLA) by my mentor Professor Jon van Rood, who still joins every lab meeting as emeritus. Genetic HLA variants provide both the strongest risk to, and protection against, type 1 diabetes.

2. What about your new post at City of Hope are you most looking forward to?

I am particularly excited by City of Hope’s ambitious goals – we want to cure type 1 diabetes and nothing less! City of Hope has a spectacular reputation in diabetes research that deserves more recognition. Arthur Riggs, Ph.D., and his colleagues cloned recombinant insulin, among many other achievements. Working with this hero is what every young student, myself included, wishes to do. 

City of Hope has also become one of the top clinical islet transplant centers in the world thanks to Fouad Kandeel, M.D., Ph.D., and his dream team. There are many things that I could learn from my peers in oncology and cell therapy, including fine diagnosis and personalized, or precision, medicine. With my new colleague, Debbie Thurmond, Ph.D., we can begin to understand the dialogue between the immune system and pancreatic islets, and perhaps modulate this dialogue favorably.

3.  What do you wish more people understood about diabetes?

I wish that we’d stop telling folks that type 1 diabetes is inherited. It is not! Let’s not blame the parents. In fact, the genes that predispose someone to type 1 diabetes were actually winners in the Middle Ages, allowing carriers to beat and survive plagues. These “risk” genes can actually also protect against cancer, so there is nothing wrong with the genes of a type 1 diabetes patient. Also, I am becoming more and more optimistic that we can actually stop this disease. We just need a better understanding of which treatments to offer which patients. 

The growth in insight and change in paradigms around this disease that I have had the honor and pleasure to experience in the last few decades are matched by only very few diseases. The future for patients with type 1 diabetes will be completely different from what it used to be. 

Finally, it turns out that the majority of diabetes patients retain beta-cells, which produce insulin, but they are sort of hibernating once the immune attack on islet cells begins. This could suggest that once we stop the immune attack, we can reactivate the beta-cells. This would not only restore a patient’s original source of insulin, but may also help prevent complications and improve the quality of life. That would make my dream, and life’s quest, come true.

4.  What research or clinical trial are you currently the most excited about?

I can’t even begin to tell you how many exciting and promising immune intervention strategies we are planning and assessing at this very moment. My own pet projects include a novel vaccination strategy using the patients’ own immune cells, which are treated with vitamin D3. I’d rather negotiate with the immune system and teach it how to do things right, than to suppress it into submission with drugs. And then there are the famous regulatory T cells of Fouad Kandeel, as well as the mesenchymal stromal cells and the mixed microchimerism of my colleague DeFu Zeng, M.D.  

5.  What drives your mission to cure people of type 1 diabetes?    

That is actually a difficult question that always makes me emotional. I just cannot accept that we have nothing better to offer people with type 1 diabetes. It has become my life’s mission to change this. With all the blessings and discoveries that this mission has brought, this profound need to serve the type 1 diabetes community has only grown. 

Life for people with type 1 diabetes has already changed in my lifetime, but there is still more to be done before we can be satisfied. I am excited to be given a chance here at City of Hope to join forces with so many motivated clinicians, researchers and patients. It is good to say “we can”, but even better to actually have done it. 

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Learn more about our diabetes research and treatment. If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.

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