Ozempic and Wegovy have become household names for treating obesity and type 2 diabetes (T2D). Medicines like these — called glucagon-like peptide-1 receptor agonists (GLP-1s) — may have other unexpected benefits: Some people taking GLP-1s experience improvements in autoimmune disease symptoms, according to recent studies.

These findings intrigued Sarah Kobernat, PhD, postdoctoral fellow in BRI’s Long Lab. She mapped out a plan to explore how and why this happens using biorepository samples. The proposed research earned her a fellowship and funding from the American Diabetes Association.

How do GLP-1s impact the immune system?

GLP-1 medications treat obesity and T2D by slowing digestion and helping people feel full. But they may also affect the immune system — specifically, how immune cells use energy.

Scientists know that different immune cells rely on different fuel sources. Effector T cells, which drive autoimmune attacks, use one fuel source. Regulatory T cells (Tregs), which help control those attacks, use another.

That difference raises an important question: Could GLP-1s shift the balance between these cells?

She will then expand the study to include more people with T1D, as well as people with T2D and healthy controls. Finally, she will examine samples from individuals already taking GLP-1s who also have an autoimmune disease to see whether similar immune changes occur.

“We hope to better understand how these medications interact with the immune system in T1D and T2D,” Dr. Kobernat said.

Targeting the cells in T1D

T1D is typically treated by replacing insulin, but that doesn’t stop the immune system from attacking insulin-producing cells. This research examines if GLP-1s could go beyond replacing insulin and influence the cells that cause autoimmune disease.

“If GLP-1s really do target the cells involved in T1D, they may be beneficial in other autoimmune diseases too, because Tregs and effector T cells are involved in many autoimmune diseases,” Dr. Kobernat said. “I’ve lived with T1D for most of my life, so it’s really meaningful to be spearheading this work.”