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this post was submitted on 29 May 2024
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I literally worked in a research lab working on islet cell therapies for diabetes in the US. This has actually been done many times before with cells from cadavers. It has been successful, although most the of the time the person reverts back after a few years
The issues we were trying to solve in the lab were
Finding a good place to transplant where the cells will last: Implanting in the hepatic region (liver), which is the most common place to implant, is toxic to the cells over time hence only lasting 3-5 years. The cells need a really good blood supply and the volume you're transplanting can't be easily transplanted in the pancreas or kidney capsules (where many successful studies were performed in mice and rats)
Being able to consistently make a high volume of stem cells that are fully grown into insulin producing cells: Cadaver cells usually require 3-5 donors for 1 person and require the receiver to be on lifelong immunosuppresors due to the immune response. Depending on the kind of stem cells, the patient may still even need immunosuppresors due to the cell type you're converting from
All this the say - the article says nothing about where the cells where transplanted, where they came from, or whether the person has Type 1 or Type 2 diabetes. Although it is still a feat, it is likely not the first time it has been done, and we're still a long ways off from a cure
"The new therapy involves programming the patient's peripheral blood mononuclear cells, transforming them into "seed cells" to recreate pancreatic islet tissue in an artificial environment."
I don't see anything for the other two questions though but being patient derived would seem to fix your number 2.
Unfortunately, that doesn't necessarily negate the requirement for immunosuppresors or some other kind of immuno protection. If it is Type 1 diabetes, the person originally became diabetic because the immune system saw certain markers on the beta cells (insulin producing cells) as a threat. So, if you recreate the beta cells, there is still a possibility that it will happen again. You are fighting your own immune system. Someone in our lab was studying encapsulation of cells to create a protective barrier around them for this very issue
If the person was Type 2, this might be less of a risk since type 2 can also be due to high insulin resistivity. There are a lot of other factors involved, though, it's not straightforward
1 patient, T2 since mid-30s and now 59, had kidney transplant 2017 after end-stage diabetic nephropathy and fucked glucose control since 2019. The successful cells were endoderm stem cells from him cultivated by mice they injected with his PBMCs that they then made diabetic. So not from cadavers (except mouse cadaver i guess), which is the actual new part here. Intrahepatic implant, and cells from unrelated donor failed that were embedded at the same time. His personalised mouse-donor cells worked well enough to take him off insulin 3 months later.
Wu, J., Li, T., Guo, M. et al. Treating a type 2 diabetic patient with impaired pancreatic islet function by personalized endoderm stem cell-derived islet tissue. Cell Discov 10, 45 (2024).
It's good news, but you're entirely correct that the article missed the point entirely. Thanks for the crash course in islet cell therapy!
Yeah they don't say the type but based just on what we are discussing I would be a bet its type 2.
Hehehehehe
Interesting. So if you chose the hard route (implant in the pancreas through invasive surgery) would that effectively cure you? I'm betting many people would be willing to take the risks
The pancreas is not really stable enough to be implanted in at all. Other organs you're imagining like liver, stomach, heart, etc. have a solid lining that can be cut open and stitched back together. The pancreas is more like a cluster of loose cells with veins throughout and held together by a very thin, tissue paper lining. If you try to open it and insert cells, you're not going to be able to put it back together.
That's why cells are usually put in the liver, which has a large vein going directly to the pancreas. Close proximity and high blood supply. Implanting in the pancreas will likely never be an option unless you can drastically reduce the volume of cells.
Our lab was working on implanting the stem cells on a porous scaffold in the fat pad of the stomach as an alternative
Short answer is no, not long-term.