‘Big milestone:’ Insulin-producing cells grown from patient’s own stem cells safe for transplant shows Edmonton research

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Insulin-producing cells grown from a patient’s own stem cells are safe for transplant, say University of Alberta (U of A) researchers aiming to get diabetes patients off injected insulin forever.

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The researchers include the U of A’s James Shapiro who led the team that developed the Edmonton Protocol in the 1990s — the process that allows successful transplantation of donated insulin-producing islet cells into the livers of people with Type 1 diabetes, freeing most from the need for daily insulin injections. Those patients, however, still need anti-rejection drugs, which can increase the risk of cancer and kidney damage. The number of donated islet cells available is also limited.

The goal of the research now is to develop an unlimited supply of islet cells that can be transplanted without the need for anti-rejection drugs, said a Tuesday news release from the U of A.

The research team’s had early success in a first-in-humans clinical trial to test whether pancreatic cells grown from a patient’s own stem cells can be safely implanted and begin to produce insulin.

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Of 17 patients who received implants, 35 per cent showed signs in their blood of insulin production after meals within six months of the implant, and 63 per cent had evidence of insulin production inside the implant devices when they were removed after a year.

“This is a very positive finding,” said Shapiro, professor of surgery, medicine and surgical oncology in the U of A’s Faculty of Medicine & Dentistry and Canada Research Chair in Transplant Surgery and Regenerative Medicine.

“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.”

In the trial, adult diabetes patients at six centres in Canada, the United States and Europe received implants of several small permeable devices filled with millions of cells each. The cells were taken from the patients’ own stem cells, then chemically transformed into stem cells programmed to become islet cells.

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The team reported on its proof of concept and safety study in a newly published paper in the journal Cell Reports Medicine.

Shapiro said that while determining safety was the main goal of this phase of the trial, at least one patient who had 10 devices implanted was able to significantly cut her insulin dose, indicating potential effectiveness.

The next step will be to determine how many stem cell-derived pancreatic cells are needed for transplant to optimize insulin production in both Type 1 and Type 2 diabetes patients.

“We’ve seen a lot of advances in the last 100 years since the Canadian discovery of insulin,” said Shapiro, who began the search for better diabetes treatment 38 years ago. “The race isn’t over yet, but we’re on our last laps and I really do believe that we can cross that ribbon.

“Cell-based therapies have the promise to deliver something far better than insulin therapy.”

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