Innovative Approaches to Treating Type 1 Diabetes Addressed in Beta-Cell Replacement Presentations

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Jun 11, 2016, 10:54 ET

NEW ORLEANS, June 11, 2016 /PRNewswire-USNewswire/ -- Transplanting islet cells from pigs into humans and developing "universal donor" stem cell lines are two innovative approaches being explored for replacing deteriorating beta cells in people with type 1 diabetes, investigators explained during a news briefing and symposium on June 10, 2016, at the American Diabetes Association's 76th Scientific Sessions^® at the Ernest N. Morial Convention Center in New Orleans.

Transplanting Pig Islet Cells
Pancreatic islet cell transplantation—using islet cells from the pancreas of a deceased human organ donor—has been successfully performed in patients with type 1 diabetes whose blood glucose levels are difficult to control. The procedure can improve blood glucose control, temporarily eliminate the need for insulin injections and improve a patient's ability to detect hypoglycemia. It is still considered experimental, however, and, due to a shortage of donors, only approximately 1,000 such surgeries have been performed during the last decade.

There is growing evidence to suggest that pig islet cells could provide a viable substitute for human pancreatic islet cell transplantation. David K.C. Cooper, MD, PhD, FRCS, Professor of Surgery, Thomas E. Starzi Transplantation Institute, University of Pittsburgh School of Medicine, reviewed progress to date on treating diabetes with the transplantation of pig pancreatic islet cells that produce insulin, during his symposium presentation, "Pig Islet Xenotransplantation."

Previous studies have shown successful transplantation of pig islet cells into nonhuman primates (monkeys) with diabetes.[1] "Monkeys with diabetes who received pig islet transplants and received immunosuppressant drug therapy experienced survival rates of more than one year with no need for insulin injections and no major complications," said Cooper.

He noted, "there have been steady improvements in the results of transplantation of pig islets and organs—for example kidneys—especially from genetically engineered pigs (whose organs and cells are protected to a large extent from the human immune response), into nonhuman primates over the past several years."

"We are getting closer to initiating trials of pig islet transplantation in human patients with diabetes in whom control of blood sugar is proving difficult," he said. "With adequate research funding to confirm our recent progress, pig islet transplantation could soon be offered to patients with poorly controlled diabetes."

"If successful, transplanting pig islet cells into people with type 1 diabetes could help patients maintain normal blood glucose levels without the need for insulin injections, an important benefit for people who experience life-threatening episodes of hypoglycemia following injections," he explained. "Improved glycemic control from transplantation could also help to prevent later diabetes-related complications such as kidney failure," he added.

Gene Editing
Autologous transplantation, in which a person's undifferentiated stem cells are removed, grown into a different type of cell and then transplanted back into his or her own body, is another experimental approach for treating degenerative diseases including diabetes. Chad A. Cowan, PhD, Associate Professor in the Department of Stem Cell and Regenerative Biology at Harvard University and Massachusetts General Hospital, an Associate Member of the Broad Institute and a Principal Faculty member of the Harvard Stem Cell Institute where he directs the Diabetes Disease Program and the iPS Cell Core Facility, will share his work in a presentation titled "Universal Donor Stem Cells: Removing the Immune Barrier to Transplantation using Gene Editing."

"Autologous transplantation has not been considered a viable option since the patient's immune system would attack the new cells, however, there may be a way around this 'immune barrier,'" said Cowan. He and his team are currently investigating the possibility of creating "universal donor" pluripotent stem cell (udPSC) lines that could be induced to grow into insulin-producing pancreatic beta cells. "Analogous to the O-negative 'universal donor' blood type, udPSCs could be used for all cell-based transplantation therapies in all patients without immune rejection," he theorized. "Once created, the next step would be to test these udPSC stem cell lines in a humanized mouse model of type 1 diabetes," Cowan said.

"If successful, our proposed work could have an enormous impact on regenerative medicine. It could lead the way to rigorously tested universal donor stem cells that could be grown and differentiated into very large numbers of cells, made widely available to all medical institutions and used on demand to treat patients suffering from type 1 diabetes and a variety of degenerative illnesses," Cowan concluded.

The American Diabetes Association's 76th Scientific Sessions, to be held June 10-14, 2016, at the Ernest N. Morial Convention Center in New Orleans, is the world's largest scientific meeting focused on diabetes. The 2016 Scientific Sessions is expected to attract more than 16,000 attendees and offers researchers and health care professionals from around the world the opportunity to share ideas and learn about the significant advances in diabetes research, treatment and care. During the five-day meeting, attendees receive exclusive access to more than 2,500 original research presentations, participate in provocative and engaging exchanges with leading diabetes experts, and can earn Continuing Medical Education (CME) or Continuing Education (CE) credits for educational sessions. The program is grouped into eight theme areas: Acute and Chronic Complications; Behavioral Medicine, Clinical Nutrition, Education and Exercise; Clinical Diabetes/Therapeutics; Epidemiology/Genetics; Immunology/Transplantation; Insulin Action/Molecular Metabolism; Integrated Physiology/Obesity; and Islet Biology/Insulin Secretion. Margaret A. Powers, PhD, RD, CDE, President, Health Care & Education, will deliver her address on Saturday, June 11, and Desmond Schatz, MD, President, Medicine & Science, will present his address on Sunday, June 12. The top eight abstracts of this year's Scientific Sessions will be presented on Tuesday, June 14, in the Presidents Oral Session. In total, the 2016 Scientific Sessions includes 378 abstracts in 50 oral sessions, 2,021 poster presentations including 59 moderated poster discussions, and 335 published-only abstracts. The Association's 2016 Scientific Achievement Awards and Lectures are:

Barbara B. Kahn, MD, Banting Medal for Scientific Achievement, the Association's highest honor. Kahn will deliver the Banting Medal Lecture, "Adipose Tissue, Inter-organ Communication, and the Path to T2D," on Sunday, June 12.
Tamas L. Horvath, DVM, PhD, Outstanding Scientific Achievement Award (OSAA), will present his OSAA Lecture, "Hunger-promoting Hypothalamic Neurons Control System Metabolism and Drive Complex Behaviors and Longevity," on Monday, June 13.
Sheri R. Colberg-Ochs, PhD, FACSM, Outstanding Diabetes Educator, will present her Lecture, "From Froot Loops^® to Fitness—My Journey as an Educator and PWD," on Saturday, June 11.
Edward W. Gregg, PhD, Kelly West Award for Outstanding Achievement in Epidemiology, will deliver his Lecture, "The Changing Tides of the Diabetes Epidemic—Smooth Sailing or Troubled Waters Ahead?," on Sunday, June 12.

Additional scientific research will be presented during 110 Symposia and nine Professional Interest Group sessions. The 76th Scientific Sessions also includes presence from more than 130 corporate and organizational exhibitors in nearly 100,000 square feet of exhibit space. Join the Scientific Sessions conversation on Twitter, #2016ADA.

About the American Diabetes Association
The American Diabetes Association is leading the fight to Stop Diabetes^® and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, the Association's mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. For more information, please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit diabetes.org. Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

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[1] Park C-G, Bottino R, Hawthorne WJ. Current status of islet xenotransplantation. Int J Surg (2015) 23: 261-266.

SOURCE American Diabetes Association