Cures are extremely rare in medicine, so news that scientists are attempting to create a functional cure for type 1 diabetes has gotten a lot of attention. A genetic disease, diabetes type 1 requires a lifetime of careful management of blood sugar levels. Researchers are now trying to use an implant made from stem cells to treat the condition. As blood sugar rises, the implant senses it and release insulin in response.
In type 1 diabetes, the immune system attacks pancreatic cells that make insulin, destroying them. Scientists have been trying to find a way to replace them for a long time, and have faced many challenges in the process. A company called Viacyte may now be successful in that endeavor.
Their credit-card sized implant is made up of stem cells that mature after they are put into the body, growing into islet cells, the ones that release insulin and get ruined by type 1 diabetes. The implant is supposed to sit just under the skin and should work automatically.
“If it works, we would call it a functional cure. It’s not truly a cure because we wouldn’t address the autoimmune cause of the disease, but we would be replacing the missing cells,” noted Paul Laikind, of Viacyte.
A trial of this method showed that when implanted into the bodies of 19 diabetics, the cells were able to develop into islet cells. In that test, they did not use enough cells to see if it effectively treated diabetes, however.
Two people have now been implanted with the device – PEC-Direct packages that contain the cells within a porous fabric. After implantation, blood vessels can grow through the outer fabric and nourish the islet progenitor cells within. It is hoped that after the cells are fully matured, they will respond to blood sugar levels – releasing insulin if necessary. Learn more about the device from the video.
If it works, this treatment could help many people, and stem cells can simply be grown for the purpose. “A limitless source of human insulin-producing cells would be a major step forward on the journey to a potential cure for diabetes,” says James Shapiro at the University of Alberta, Canada, who has collaborated with Viacyte on this project, and who pioneered the donor pancreas method decades ago. “For sure, this will in the end prove to be a durable landmark for progress in diabetes care.”
“Islet transplants have been used to successfully treat patients with unstable, high-risk type 1 diabetes, but the procedure has limitations, including a very limited supply of donor organs and challenges in obtaining reliable and consistent islet preparations,” said trial investigator James Shapiro, MD, PhD, FRCSC, the Director of the Clinical Islet Transplant Program at the University of Alberta. “An effective stem cell-derived islet replacement therapy would solve these issues and has the potential to help a greater number of people.”
“Patients with high-risk type 1 diabetes complications, such as hypoglycemia unawareness, are at constant risk of life-threatening low blood glucose,” commented clinical trial investigator Jeremy Pettus, MD, an Assistant Professor of Medicine at UC San Diego. “The PEC-Direct islet cell replacement therapy is designed to help patients with the most urgent medical need.”
This invention could be a breakthrough for people with type 1 diabetes, who must constantly monitor their blood sugar and inject insulin as needed. Immunosuppressant drugs would have to be taken with the implant, however, so the cells would not be rejected.
“If successful, this strategy could really change the way we treat type 1 diabetes in the future,” commented Emily Burns, of the charity Diabetes UK.
Source: New Scientist, Viacyte
