Type 1 diabetes is an auto-immune condition whereby the patient’s own immune system attacks the pancreatic islets, destroying them in the process. Since these islets are responsible for producing insulin in response to blood sugar (glucose) levels, the patient is thus required to externally inject insulin for the remainder of their life. That was the expected scenario, but it appears that this form of diabetes may soon be treatable, with one woman now being free of the condition for a year already, as reported in Nature, referencing an article by [Shusen Wang] et al. that describes the treatment and the one-year result.
Most notable with this study is that the researchers didn’t use the regular method to create pluripotent stem cells. These cells were extracted from the patient, to revert back to this earlier developmental stage. They were not modified using genes, but rather singular chemicals (PDF). The advantage of this is that it avoids having to modify the cell’s genomes, which could conceivably cause issues like cancer later on. This was one of the first time that this method was used in a human subject, with islet cells formed and about 1.5 million of them injected into the patient’s abdominal muscles, a novel site for this procedure.
This location made these islets easy to keep track of, and easier to remove in case of any issues compared to the usual injection site within the liver. Fortunately for this woman, no complications occurred and one year later she is still free of any diabetes symptoms. Two other patients in the trial are also seeing very positive results, leaving only the question of whether the auto-immune condition that originally caused the islet destruction still exists. Since this female patient is taking immunosuppressants for a previous liver transplant it’s a hard to thing to judge, especially since we understand the causes behind type 1 diabetes so poorly.
Regardless, this and other trials using pluripotent cells, transplanted islets and more offer the prospect of a permanent treatment for the many people who suffer from type 1 diabetes.
Featured image: “Human induced pluripotent stem cell colony” National Eye Institute/NIH
The trick of trying this in an already immune suppressed patient is insightful. But for the public please consider what one of my heme-Onc professors always said. This is trading one terrible disease for another. Total immune suppression (for organ transplant, autoimmune disease, bone marrow transplant etc) is soooo not without its own problems. And, per usual, I would prefer not to defend the “gotcha!” Replies, if any.
Supposing it only works in immune-suppressed patients with type 1 diabetes. That’s still a huge win for those patients, provided it ever gets to market. With a limited audience, the company might pull the plug before it gets approved.