Insulin-producing pancreatic cells could treat diabetes 1

Clusters of insulin-producing pancreatic cells that can be given to type 1 diabetics could be the first step toward a cure, researchers say.

From stem cells, a team at the Salk Institute in La Jolla, California, made beta-like cells that produce insulin in response to glucose.

When these cells were transplanted into diabetic mice, controlled blood glucose and the rodents did not need to be given immunosuppressive drugs.

The treatment is experimental and in early stages of testing, but scientists believe its powerful effect could be a game-changer in the treatment of diabetes.

According to the Centers for Disease Control and Prevention, 30.3 million Americans – about 9.4 percent of the population – suffer from diabetes.

However, only about five to 10 percent of those with diabetes have type 1.

It occurs when there are too few beta cells in the pancreas to produce insulin or when they produce very little insulin, the hormone needed to get glucose from the bloodstream into cells.

If left untreated, diabetes can result in serious health complications such as kidney damage, eye damage, heart disease, stroke and even vision loss.

“Most type 1 diabetics are children and teenagers,” said Dr. Ronald Evans, a professor and director of the Gene Expression Laboratory at the Salk Institute.

‘This is a disease that has historically been difficult to manage with drugs. We hope that regenerative medicine combined with immune protection can make a real difference in the field by replacing damaged cells with lab-generated human islet cell-like clusters that produce normal amounts of insulin on demand. ‘

Many patients with Type 1 diabetes experience transplants of pancreatic beta islands – clusters of cells that make insulin and other hormones – of donor tissue.

While this may provide a cure, it also requires her to take immunosuppressive medications for the rest of her life to prevent rejection.

Earlier, the team discovered that a protein-coding gene called ERR-gamma ‘turbo-charged’ stem cell-derived beta cells that produce insulin in response to glucose.

“When we add ERR gamma, the cells have the energy they need to do their job,” said co-author Dr. Michael Downes, a scientist on senior staff at Salk.

‘These cells are healthy and robust and can supply insulin when they are feeling high glucose levels.’

For the new study, published in Nature, the team focused on how these beta-like cells grow in an environment similar to the human pancreas.

They found another protein-encoding gene, WNT4, triggers a switch in which the beta-like cells can reach their fully functional state that mimics islets in the pancreas.

To prevent immune rejection, they used the protein PD-L1, which keeps immune cells from attacking non-harmful cells in the body.

‘By expressing PD-L1, which acts as an immune blocker, the transplanted organoids are able to hide from the immune system,’ said first author Dr Eiji Yoshihara, a former human resources scientist at the Salk Institute.

When these were completed clusters transplanted into diabetic mice, they controlled blood glucose control and were not attacked by the immune system.

The team hopes to do more experiments in mice and prove that it is also safe for humans.

“We now have a product that could potentially be used in patients without requiring any kind of device,” Evans said.