Study reveals new cell transplantation technique for type 1 patients

Tue, 29 Oct 2013
A patient with type 1 diabetes has become the first to have insulin-producing cells successfully transplanted into their body without the use of immune-suppressing medications, offering new hope for type 1 diabetics.

In type 1 diabetes, islets - clusters of cells within the pancreas which include insulin-producing beta cells - are destroyed by the body's own immune system, leaving patients without enough insulin to survive.

Researchers have been able to transplant replacement islet cells into type 1 diabetes patients to kick-start the production of insulin, but not without using drugs to dampen the immune system's response to the foreign cells (immunosuppression), which can come with dangerous side effects.

But in a new study, published online in the Proceedings of the National Academy of Sciences journal, researchers in America have demonstrated a way to implant foreign islet cells and protect them whilst avoiding the use of immunosuppression.

This new technique involves the use of a semi-permeable chamber, specially designed to store the new islet cells and effectively hide them from the patient's immune system.

To ensure the islet cells are able to establish their own blood supply and receive oxygen in the chamber, an oxygen port on the outside of the body was attached to the device via tubing that had to be manually refilled daily for up to two months.

The device was implanted into a 63-year-old man of average weight, who'd been living with type 1 diabetes since the age of 9 but didn't suffer from any serious diabetes-related complications.

Following the transplant, the research team conducted blood tests which showed modest rises in his C-peptide levels. C-peptide is a by-product of insulin production, so increasing levels of the substance indicated normal islet cell function. In addition, both his C-peptide and insulin levels rose rapidly in response to an injection of glucose.

Over time, the patient experienced a slight improvement in his long-term blood sugar control as well as a decrease in his insulin medication needs. After 10 months, there were also no signs of possible cell rejection or that the immune system was even aware of the new islets.

Study co-author Professor Norman Block, of the Endocrine Polypeptide and Cancer Institute at the Veterans Affairs Medical Center in Miami, explained the new transplant technique can also help with the problem of limited availability of islet cells for transplant, as it allows for the use of both human or porcine (pig) islets.

"Going to xenotransplantation [procedures that involve animal-human transplants of cells, tissues or organs] could be a future step that would enable an unlimited number of islet cells that produce human-like insulin," he said.
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