About:

Dr Pia Leete is a Diabetes UK RD Lawrence Scholar and Senior Independent Research Fellow at the University of Exeter.  Her team focuses on understanding the heterogeneity of the immunopathology of type 1 diabetes in the pancreas and how this relates to age and beta-cell loss.  This work has been generously supported by funds from Diabetes UK via project grants, a prestigious early career fellowship, and funding from the Exeter Centre of Excellence in Diabetes E3 fund.

Dr Leete’s expertise is centred around characterising histological features of type 1 diabetes in the pancreas by employing samples from rare and global biobanks such as from JDRF’s network of Pancreatic Organ Donors with Diabetes (USA), the Exeter Archival Biobank (UK) and the Detection of Virus in Diabetes Study (Norway).  These precious samples, derived from individuals at different ages and disease durations, offer the team a window through which to explore the pancreatic landscapes in health and disease.  The group and their collaborators now merge state-of-the-art histology and imaging techniques with mathematical modelling, aiming to understand the aetiology of this impactful condition better.

In addition to her research, Pia established the RILD imaging facility and bioimaging forum, recruited an exceptional image data specialist, and is a long-serving and committed EDI ally for all and a wellbeing and menopause champion for the college.

Pia’s Career and Research Trajectory:

Written also to be accessible for those not familiar with diabetes basic science research:

Pia transitioned from the arts into science in her early forties, and her PhD focussed on characterising how the immune system appears to go wrong in the pancreas in type 1 diabetes.  Supervised by Professors Noel Morgan and Sarah Richardson, she capitalised on her early training as an artist to further develop her visual patterning skills and become an expert in image analysis and pattern recognition in datasets. 

Also, a trained person-centred counsellor in her pre-science life, Pia has always been driven to understand what makes us different and where we are the same – and she has carried this curiosity into her career as a scientist. 

Looking beyond the n-numbers usually required of a PhD student, and by studying images and data accrued from archival histological samples of pancreas collected from young people who had had tragically died of diabetic ketoacidosis, Pia quickly observed the surprising fact that the misplaced attack of the insulin-producing beta-cells by a person's own immune system, in the pancreas in T1D, does not look the same in all people, despite the uniformity of the way people are diagnosed with the condition.  This heterogeneity has formed the basis and foundation of her work ever since.

Her PhD findings described that whilst some young individuals exhibit a highly inflamed, B-lymphocyte enriched immune invasion of their islets and lose all their beta-cells very quickly after diagnosis, others (often diagnosed beyond early teen-hood) show little evidence of a prolific immune attack and retain surprising numbers of beta-cells, often for many years. This work is now thought to support the idea that some immunotherapies, aimed at prevent T1D, may only work in the very youngest of at-risk children.

We now also assume the long-lived islets (in those diagnosed with T1D at older ages) are dysfunctional (and therefore potentially hidden from the immune system) in some way, because, despite the continued presence of these beta-cells, these individuals still have an absolute requirement for insulin therapy.

As a post-doc, she continued to explore her passion for understanding the heterogeneity of T1D, and went on to discover that the beta-cells also look  to be behaving differently between those individuals whose islets suffered a violent immune invasion, vs those that appeared to have islets which evade the misdirected auto-immune attack.  In these latter individuals, having beta-cells which remain intact, but apparently quiescent or blind to the signals which would normally trigger them to secrete the lifesaving insulin required to regulate blood glucose, offers hope for therapeutic intervention aiming to illicit a non-invasive functional cure for T1D.

Based on these findings, she, her supervisors, and their clinical collaborators proposed that these two novel but discrete findings might indicate the existence of two distinct forms of the disease, suggesting the possibility of "endotypes" of diabetes.

Thus, combined, these two novel observations lent weight to the proposal that a deeper understanding of the heterogeneity in type 1 diabetes could support the design of more targeted interventions. Several research groups have carried this idea forward, and it has become a focus of some sizeable grant applications at Exeter. It remains the focus of her group's work, where she firmly believes that whether endotypes (per se) exist or if there are a more random set of interpersonal differences - understanding where the disease manifests differently (or the same) between individuals is critical to solving the riddle of how to treat, and even prevent the condition in all people.

Awards

• RD Lawrence Fellowship (2023-2027)
• FHEA Fellowship
• 11 Above and Beyond Awards (University of Exeter)
• Excellence in Biology (University of Plymouth)

Research group links:

Department of Clinical and Biomedical Sciences

and Islet Biology Group (www.isletbiologyexeter.com)

Qualifications:

• 1st class Hons in Human Bioscience
• PhD focussed on the Heterogeneity of the Pancreatic pathology in T1D
• Fellow of the Higher Education Authority