The Frontiers of Knowledge Award goes to the researchers who laid the biological foundations for revolutionary new treatments in diabetes and obesity

The combined work of Daniel Joshua Drucker (Mount Sinai Hospital, Canada), Joel Habener (Harvard University, USA), Jens Juul Holst (University of Copenhagen, Denmark), and Svetlana Mojsov (Rockefeller University, USA) uncovered the biological role of the hormone GLP-1. This hormone is essential for regulating glucose levels and controlling appetite. According to the committee of the Frontiers in Biology and Biomedicine Award, “These findings have been exploited to develop novel therapeutics for treating type 2 diabetes and obesity.”

In the exploration of the biological roots of obesity, the laureates’ findings intersect with the insights of Douglas Coleman and Jeffrey Friedman on the role of another hormone, leptin, in regulating appetite and body weight, distinguished in 2013 with the 5th Frontiers of Knowledge Award in Biomedicine.

Moreover, treatments based on the GLP-1 hormone have shown exciting therapeutic potential in neurological conditions, like Parkinson’s and Alzheimer’s, and addiction disorders, with studies now underway to gauge their effectiveness.

The discovery of a fundamental hormone

In the past two decades, GLP-1 has marked a game-changing advance in the treatment of both type 2 diabetes and obesity. Various diabetes treatments were already in use, but the advantage of GLP-1 was that it only stimulated insulin production when blood sugar levels were high, dramatically reducing the risk of them dropping below the safe limit. For the first time, patients were freed of the need to continually measure their blood sugar, since the drug itself would regulate its level.

In addition, being overweight can worsen outcomes with type 2 diabetes. Yet most previous treatments caused weight gain, diminishing their overall effectiveness. With GLP-1, this side effect not only disappears, but the drug actually helps patients lose weight, providing a two-way improvement in the disease prognosis. Recently, moreover, these new medications have been observed to reduce the risk of other complications of type 2 diabetes, including blindness, kidney disease and heart attacks.

On the obesity score, they have achieved first-time reductions in body mass ranging from 15% to 20%, beyond anything witnessed with existing treatments. And, as with diabetes, GLP-1 drugs also reduce obesity-related risks, among them cardiovascular disease.

Exciting potential for the treatment of neurodegenerative and addiction disorders

The committee stressed that the impact of the four scientists’ fundamental discoveries is not confined to the development of novel therapeutics for diabetes and obesity. They have also spawned a new research field exploring their treatment potential for other disorders like degenerative diseases and addictions. Indeed right now, as Mojsov states, “the pharmacological use of GLP-1 analogs for treatments of addiction and neurological disorders are being evaluated in clinical trials.”

GLP-1 based treatments have also been shown to have a powerful anti-inflammatory effect, and as such hold out considerable promise in neurodegenerative conditions. Drucker is currently exploring this avenue with his team at Mount Sinai Hospital in Toronto.  “We are taking an in-depth look at the drugs’ effects against inflammation processes, a line of research that I am particularly excited about. We want to understand this mechanism to see, for example, whether it could be effective in reducing inflammation in the brain as a way to combat Alzheimer’s disease. The science here holds great promise and we have a large number of trials underway studying whether GLP-1 medicines will be potentially useful in these conditions. I’m really looking forward to the results.”

Holst believes that GLP-1 drugs may find use in treating drug addiction disorders, since “they have quite a pronounced effect on the reward center in the brain.” So “just as these treatments inhibit food reward as a means to suppress appetite and achieve weight loss, they might also serve to reduce dependence on alcohol and other addictive substances.”

Says Drucker, “what I’m most excited about going forward are new innovations in the field that will bring GLP-1 drugs to many millions of people who currently can’t access these medicines, enabling the health benefits to be extended not just to rich countries that can afford them, but to people all over the world.”