Stem cell-derived islet transplantation provides insulin independence for type 1 diabetes

Type 1 diabetes, a chronic disease that affects millions of people worldwide, continues to be the subject of intense research and development. As scientists advance in understanding this autoimmune disease, new strategies and treatments are emerging that promise to improve the quality of life for those who suffer from it, as well as promote better control of blood glucose levels.

In this context, a 25-year-old woman with type 1 diabetes began producing her own insulin less than three months after undergoing transplantation of reprogrammed stem cells. The study, published in the journal Cell, marks a major milestone as it is the first person with the disease to be treated with cells extracted from their own body. The work builds on findings from an independent group in Shanghai, China, which in April reported the successful transplantation of insulin-producing islets into the liver of a 59-year-old man with type 2 diabetes. In this case, the islets were obtained from reprogrammed stem cells extracted from the patient’s own body, who has since stopped needing insulin.

These studies are part of a limited group of innovative studies that They use stem cells to treat diabetesa disease that affects almost 500 million people worldwide. Most sufferers have type 2 diabetes, in which the body does not produce enough insulin or has difficulty using the hormone effectively. On the other hand, in type 1 diabetes, the immune system attacks the islet cells of the pancreas.

Islet transplantation

Islet transplantation may be a treatment option for this disease, but shortage of donors This is an important task. In addition, recipients must be treated with immunosuppressive drugs to prevent rejection of the transplanted tissue. Stem cells are capable of generating any type of tissue in the body and can be grown indefinitely in the laboratory, suggesting that they could become an unlimited source of pancreatic tissue. By using tissue created from a patient’s own cells, researchers also hope to eliminate the need for immunosuppressive drugs.

Islet transplantation may be a treatment option for this disease, but the shortage of donors is a major problem.

In this study, they report patient outcomes after one year as a preliminary analysis of the first phase I clinical trial in humans evaluating Possibility of transplantation of autologous islets obtained from chemically induced pluripotent stem cells

(CiPSC islets) under the sheath of the rectus abdominis muscle for the treatment of type 1 diabetes.

In June 2023, the patient underwent an operation lasting less than half an hour, during which about 1.5 million islets were injected into the abdominal muscles. women, highlighting a new approach to islet cell transplantation. Unlike most grafts, which are placed in the liver and do not allow cells to be observed, placement in the abdomen allows researchers to monitor cells using magnetic resonance imaging and remove them if necessary, the researchers said.

In particular, the patient was able to maintain stable insulin independence starting 75 days after transplantation. Time in The patient’s target blood glucose range increased from a baseline value of 43.18 to 96.21. percent in the fourth month after transplantation, which is accompanied by a decrease in glycated hemoglobin, an indicator of long-term systemic glucose levels, reaching non-diabetic levels. From this point on, the patient experienced a state of stable glycemic control with time to achieve a target blood glucose level of more than 98 percent and glycated hemoglobin of about five percent.

After one year, clinical data achieved all study endpoints without evidence of transplantation-related abnormalities. These promising results indicate the need for further clinical studies to evaluate CiPSC islet transplantation for type 1 diabetes.

Since the woman has already received immunosuppressants Because of previous liver transplantation, the researchers were unable to assess whether iPS cells reduce the risk of graft rejection. Although the body does not reject the transplant because it does not consider the cells to be “foreign,” in people with type 1 diabetes who have the autoimmune disease, there is a risk that the body will attack the transplanted islets, the researchers say. However, the team is working to develop cells that can avoid this autoimmune reaction.

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