The majority of individuals have type 2 diabetes, where the body either doesn’t produce sufficient insulin or is less effective in utilizing it. In contrast, type 1 diabetes occurs when the immune system targets the islet cells in the pancreas.
While islet transplants can be a treatment option, there is a shortage of donors to meet the increasing need. Additionally, recipients must take immune-suppressing medications to avoid rejecting the transplanted tissue.
A 25-year-old woman with type 1 diabetes began making her insulin less than three months after the successful treatment of the condition.
She got a transplant of unique stem cells taken from her own body.
After over a year since the transplant, the woman can now have sweets and enjoy eating everything—especially hotpot.
James Shapiro, a transplant surgeon and researcher at the University of Alberta in Edmonton, Canada, describes the surgery’s results as amazing. He says the procedure has completely reversed the patient’s diabetes, who previously needed a lot of insulin.
In April, another group of scientists reported on the successful transplantation of insulin-producing islets into the liver of a 59-year-old man with type 2 diabetes. They obtained the islets from the patient’s own reprogrammed stem cells. Since then, the patient has stopped taking insulin.
This new study follows the results of the abovementioned study. However, these studies are among a handful of pioneering trials using stem cells to treat diabetes.
In a groundbreaking trial, Deng Hongkui, a cell biologist at Peking University, and his team extracted cells from three people with type 1 diabetes. They reprogrammed them into a pluripotent state, allowing them to become any cell in the body. This method builds on a technique developed by Shinya Yamanaka nearly twenty years ago. However, Deng’s team improved it by using small molecules instead of proteins for more precise control.
They then created 3D clusters of islets from these chemically induced pluripotent stem (iPS) cells. Later, they tested their safety and effectiveness in mice and non-human primates.
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In June 2023, they performed a procedure that took less than half an hour, injecting about 1.5 million islets into the woman’s abdominal muscles. This is a new location for islet transplants, as most are placed in the liver, where they can’t be easily monitored. By injecting them into the abdomen, the researchers could use MRI to track the cells and potentially remove them if necessary.
After two and a half months, the woman was producing enough insulin to live without it, and she sustained that level of production for more than a year. By then, she had stopped experiencing dangerous spikes and drops in her blood sugar levels, which stayed within the target range for over 98% of the day.
Daisuke Yabe, a diabetes researcher at Kyoto University, said, “That’s remarkable. If this applies to other patients, it will be wonderful.”
Jay Skyler, an endocrinologist at the University of Miami, Florida, who studies type 1 diabetes, said, “The results are intriguing, but they need to be replicated in more people.”
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Deng reports that the results for the other two participants are also “very positive” and that they will reach the one-year mark in November. After that, he hopes to expand the trial to include another 10 to 20 people.
Since the woman was already on immunosuppressants from a previous liver transplant, the researchers couldn’t determine if the iPS cells helped reduce the risk of transplant rejection.
Even if the body doesn’t reject the transplant, people with type 1 diabetes have an autoimmune condition, which means there’s still a risk that their immune system could attack the islets.
Deng noted that they didn’t see this in the woman because of her immunosuppressants, but they are working on developing cells that can avoid this autoimmune response.
Journal Reference:
- Shusen Wang, Yuanyuan Du, Boya Zhang et al. Transplantation of chemically induced pluripotent stem-cell-derived islets under abdominal anterior rectus sheath in a type 1 diabetes patient. Cell. DOI: 10.1016/j.cell.2024.09.004