Researchers at the University of Alberta say they have taken an important step in efforts to permanently prevent people with diabetes from injecting insulin.
A recent human clinical trial is reporting the first signs that insulin-producing cells grown from a patient’s own blood are safe for transplantation, and in some cases, they begin to produce insulin.
The trial saw 17 adults with diabetes at six centers in Canada, the United States and Europe receiving implants of pancreatic cells grown from their own blood.
Each patient received implants of several small, permeable devices filled with millions of cells each. The cells were taken from the blood of patients and then chemically transformed into stem cells programmed to become islets of Langerhans.
Of the 17 patients who received implants, the U of A researchers said 35% had signs in their blood of insulin production after meals within six months of implantation. On top of that, 63 percent had evidence of insulin production inside the implant devices when they were removed after one year.
“This is a very positive finding,” said James Shapiro, professor of surgery, medicine and surgical oncology in the faculty of medicine and dentistry at the University of Alberta.
“This is not the end of the game, but it is an important step on the road to success, demonstrating that islet of Langerhans stem cell therapies are safe and can begin to show some sign of effectiveness in patients. patients in the clinic. “
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Shapiro also led the team that developed the Edmonton Protocol in the 1990s, which developed a way to transplant islet cells, reducing their need for insulin. However, the U of A says patients continue to need anti-rejection drugs, which can have side effects such as an increased risk of cancer and kidney damage. The number of donated islet cells is also limited.
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Shapiro said the main goal of this phase of the trial was to ensure safety, but added that at least one patient who had 10 devices implanted was able to significantly reduce their insulin dose, indicating the potential effectiveness of the treatment.
“We’re seeing some improvement in patients’ blood sugar, but these cells are currently only being transplanted in very small amounts, so we don’t expect big changes in insulin requirements,” Shapiro said.
“But we can see in about 65% of the devices that we remove under the skin that there are human insulin-producing cells that survive, and in about a third of patients, they have measurable levels of insulin in the skin. blood So it’s a very good first start with this treatment, I’m very excited about it.
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The ultimate goal of the new research is to develop an unlimited supply of Islet of Langerhans cells that can be safely transplanted without the need for anti-rejection drugs.
“We have seen a lot of progress in the last 100 years since the Canadian discovery of insulin,” Shapiro said. “The race is not over yet, but we are in our last laps and I really believe we can cross that ribbon.
“Cellular therapies have the promise of offering something much better than insulin therapy.
“Again, we don’t expect diabetes to be cured in the first wave, we are trying to do safety testing for the first patients. And we see this is really helping humanity in the future of diabetes rather than any particular patient at this stage, but that will change as we go along. “
The next step will try to determine how many pancreatic cells derived from stem cells are needed for a transplant to optimize insulin production in patients with type 1 and type 2 diabetes.
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