While pancreatic islet cell transplants are a potential treatment for patients with type 1 diabetes, they rarely last longer than 20 years and require patients to take immunosuppressant drugs. Now researchers at the University of Alberta in Edmonton, Canada have investigated the safety of engrafting pancreatic cells they have created in the lab into the tissues of type 1 diabetes patients.
First author professor of surgery at the University of Alberta Professor James Shapiro said: 'This is a very positive finding. It's not the endgame, but it's a big milestone along the road to success, demonstrating that stem cell-derived islet therapies are safe, and can begin to show some signal of efficacy in patients in the clinic.'
Type 1 diabetes is understood to be caused by the destruction of insulin-producing beta-cells in pancreatic islets, which results in the body not having enough insulin, a hormone required to regulate glucose levels in our blood. This disease can prove fatal if patients have too little glucose in their blood, and can cause long term damage if patients have too much.
The results of the study published in Cell Reports Medicine, reported on 17 adult patients with type 1 diabetes. Lab-grown pancreatic endoderm cells were implanted in the patients using devices that had been engineered to allow blood vessels to grow in and out of them. Multiple devices were implanted underneath the skin either in the forearm or the abdomen. All patients took immunosuppressant drugs to prevent the rejection of these transplanted stem cells by their immune system.
'The idea of the multiple small devices was so that we could remove them at different time points to see – are the cells surviving?', explained Professor Shapiro. 'Are they working? And are they doing what they're supposed to do?'
Of the 17 adult patients on this study, 63 percent showed successful engraftment of these cells as well as differentiation into islet cells and insulin expression, three to twelve months post device implantation. However, just one patient was able to reduce their insulin dose and no therapeutic benefit has been observed yet in this pilot study using these pancreatic cells created from stem cells.
Professor Shapiro and the other authors of this study, explain this is likely because not enough cells are being successfully engrafted. They believe this can be improved through further optimisations of the implant devices and how they are administered to patients.
A trial is scheduled to start in Canada in early 2022 using genetically engineered pancreatic cells created from stem cells which will not have targets recognised by the immune system of type 1 diabetics.
'The ultimate goal of the current research is to develop an unlimited supply of islet cells that can be safely transplanted without the need for anti-rejection drugs', explained Professor Shapiro.