Insulin producing cells transplanted without immune suppressing drugs

by Barbara Hewitt on October 31, 2013

For the first time insulin producing islet cells have been transplanted into the body of a person with type 1 diabetes without the need for immune suppressing medication.

An international research team used a specially designed chamber which effectively ‘hid’ transplanted cells from the patient’s immune system and thus avoiding the need to use drugs. It means that the islet cells, which are normally found in the pancreas, were still able to function and make insulin.

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An international research team found a way to implant foreign cells and protect them without using immunosuppression drugs

Dr Norman Block, professor of urologic research and clinical director of the Endocrine Polypeptide and Cancer Institute at the Veterans Affairs Medical Centre Research Service, in Miami and study co-author, explained that normally a patient would have to take immune suppressing drugs to stop the body rejecting what it regards as foreign cells.

But by using the chamber technique his team found a way to implant foreign cells and protect them without using immunosuppression drugs which need to be taken for life and can have significant risks and side effects.

Until now the transplantation of islet cells has been limited to patients who have difficulty controlling diabetes and experience repeated episodes of life threatening low blood sugar levels but this new treatment could bring help for millions.

The researchers said that a lot more work has to be done to refine the chamber technique. When islet cells are first transplanted, they haven’t established their own blood supply and aren’t able to get oxygen when they’re hiding in the chamber. For that reason, the current version of the device had an oxygen port on the outside of the body attached via tubing that has to be refilled daily by the patient for as long as a month or two, Block explained.

The patient wasn’t producing any C-peptide, a byproduct of insulin production, which is often used to measure the success of diabetes treatments in research settings. If C-peptide levels rise, it means insulin production has risen.

The researchers found that over time, the patient’s long term blood sugar control improved slightly, and need for insulin decreased, though not to the point where insulin injections were not needed.

But the real breakthrough is that fact that after 10 months there were no signs that the immune system was aware of the new cells. There were no signs of possible rejection of the new cells, and no signs that the immune system initiated an attack on the new islet cells.

The transplant only contained about half the amount of islet cells normally transplanted. ‘We only had a limited number of beta cells available from this one pancreas,’ explained Block.

Researchers are diabetes groups are excited by the development. ‘They’ve clearly shown the ability to maintain some function without immunosuppression,’ said Julia Greenstein, vice president for cure therapies at the Juvenile Diabetes Research Foundation.

However, she too pointed out that much more work needs to be done before this technique could be used more generally. ‘It’s a study of one patient, and the level of C-peptide wasn’t enough to significantly impact the clinical situation of the recipient. The goal of transplantation is normal blood sugar levels or insulin independence and neither of those goals was met in this study but it is one early step on the way to developing a practical approach to providing islet function for a person with type 1 diabetes,’ she added.

The full details of the case can be found in the Proceedings of the National Academy of Sciences.


The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

{ 1 comment… read it below or add one }

Ivan June 6, 2018 at 12:43 pm

“However, she too pointed out that much more work needs to be done before this technique could be used more”

WHY?

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