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First Successful Cell Transplant Cures Diabetes
Iphtashu Fitz writes "A few months ago the 50th anniversary of the first organ transplant was celebrated. Over those 50 years surgeons have learned how to sucessfully transplant many organs and other body parts. Now it seems that Japanese surgeons have added yet another successful transplant to the list, having recently transplanted insulin-generating cells, known as Islets of Langerhans from a mother to her diabetic daughter. Three months after the surgery both mother and daughter appear to be completely healthy. Although the daughter no longer needs insulin she still needs to take powerful drugs to keep her immune system from rejecting the new cells. Researchers also still don't know if this procedure would work in many people with type 1 diabetes since in many of those cases their own immune system has destroyed their Islet cells."
Here's the BBC article referenced by the post:
. stm
http://news.bbc.co.uk/1/hi/health/4459523.stm
And, here's a related one from last month:
http://news.bbc.co.uk/2/hi/health/4332163
Thought it has the same conclusion
This procedure was, I believe, developed and first performed in Canada. The idea has been around for a few years.
"Academicians are more likely to share each other's toothbrush than each other's nomenclature."
Cohen
cheap labor conservatives - they want to keep you hungry enough to be thankful for minimum wage.
As far as I know (being type I), immunosuppressant drugs are considered worse than insulin in general. IF your diabetes is well regulated, your health can be perfect. Immunosuppressants on the other hand seem to cause some risks.
The situation is different if the diabetes is not well regulated, for instance if the kidneys have been destroyed. In the latter case, when a kidney transplant necessitates immunosuppressants anyway, I believe it is quite common to also implant an extra pancreas (hopefully from a dead donor...) and this way curing the diabetes.
As I read the article the new thing is not to implant pancreas tissue, but rather that the donor is alive, which will of course increase the availability a little bit.
This isn't new, unfortunately. Islet cell transplants have been happening for many years now. The first cases I heard of were in Russia, using islet cells from aborted foetuses (I gather such things are more readily available in Russia). But they've been doing it on a small scale in the UK for years, too, with success.
I'm not sure why we haven't seen this become a mainstream solution yet, but personally, I'm not holding my breath for any of the diabetes solutions that get mentioned by news reporters regularly. News services seem to like to this story so much that they declare a new "cure" each year... except that it'll be years before most people get it, if they get it.
1. the pancreas does not grow back like the liver. I assume its possible to live with only half a pancreas (why would they do it if she couldnt). As i try to think back to my physiology 210 class, i think she might need to take something for digestion (much of the digestive enzymes are produced by the spleen, for breakdown in your small intestine).
2. Type I diabetes mellitus is an autoimmune disease. For some reason, the immune cells that would normally be destroyed because they are targeted towards these islet cells are not. Since they are still around, whenever they see their target, they act on them. Looking through my immunology class notes, there is a genetic basis that can predispose people to diabetes. As its almost 2 in the morning, i cant think of a way to remove these autoreactive cells.
3. the diabetes you are thinking of is Type 2 (adult-onset). Type 2 is entirely treatable, through diet and exercise. Type I, not so much.
I too question whether its better to be on insulin until a better 'cure' is found, or to be on harsh immunosuppressives forever. As a rather extreme example, AIDS patients are heavily immunosuppressed. But its not the AIDS that kills them, usually its secondary infections that run rampant because you cant do anything about it.
Dont have time to make up an account, eyes are closing. ill try to keep track of this discussion and answer any questions/comments/etc.
http://www.wrongdiagnosis.com/artic/pancreatic_isl et_transplantation_niddk.htm
"Scientists have made many advances in islet transplantation over the past 25 years. Dr. James Shapiro and colleagues at the University of Alberta in Edmonton, Canada, have used a new procedure called the Edmonton Protocol to treat eight patients with type 1 diabetes. These patients have been completely freed from insulin injections since the first transplant in mid-1999."
and:
http://cpmcnet.columbia.edu/dept/cs/programs/pancr eas/research.html
"The University of Alberta, Edmonton, Canada was the first group to successfully maintain islet transplants using islets from two organ donors and a new steroid free immunosuppressive regimen."
and:
http://diabetes.niddk.nih.gov/dm/pubs/pancreaticis let/
"Scientists have made many advances in islet transplantation in recent years. Since reporting their findings in the June 2000 issue of the New England Journal of Medicine, researchers at the University of Alberta in Edmonton, Canada, have continued to use a procedure called the Edmonton protocol to transplant pancreatic islets into people with type 1 diabetes. A multicenter clinical trial of the Edmonton protocol for islet transplantation is currently under way, and results will be announced in several years. According to the Immune Tolerance Network (ITN), as of June 2003, about 50 percent of the patients have remained insulin-free up to 1 year after receiving a transplant. A clinical trial of the Edmonton protocol is also being conducted by the ITN, funded by the National Institutes of Health and the Juvenile Diabetes Research Foundation International."
Still... an amazing area of research and one hopes it leads to a more generally available cure for diabetes (without all the immunosuppresive side effects).
If you read on to the bottom of the wikipedia article:
And following that link for Denise Faustman, you'll see that she is noted for transplanting islet cells.
So, I don't think joinlee.org would be such a bad place to donate to.
The [offline] article I read on this indicated that this case was unusual in that the girl did not have your standard type 1 diabetes but had developed it due to an inflammation of the pancreas when she was younger. As a result her immune system was not attacking her beta cells so this case is rather different from that in most type 1s whose bodies would attack implanted cells normally.
Well, I don't know about predictable... Too much insulin and they can go into diabetic coma and die, too little and they can get organ damage and have a heart attack or need their feet amputated.
The short answer is No. Immuno-suppressents are not as bad as they sound. Taking them is no big deal.
I've been on them for 4 years, since my kidney transplant. Contrary to popular belief they do not make you much more susceptible to every cold and flu going around. Obviously you are slightly more vulnerable to viral infections.. but in the last 4 years I have not suffered from any more illnesses than anyone else I know.
Generally its just one pill a day which replaces dozens of pills, a few injections and in my case, dialysis.
(talking purely about type I diabetes here)
Yeah, you're exactly correct except for the "just" word ;-). Speaking as a type I diabetic, with a type I brother and a type II stepfather and a type II stepbrother - keeping control of the blood sugar levels can be a bitch. Regardless of whether you're injecting insulin or not.
I wouldn't consider a "treatment" involving immunosuppressant drugs unless my blood sugar levels were really severely out of control (and I'd tried a variety of alternatives). Anti-rejection drugs suck.
I was much more excited about the Glucowatch product (nice asynchronous, albeit approximate, blood sugar monitoring tool), but I first heard about it a couple of years ago and still haven't seen any sign of them being available in Australia. Motherfuckers.
In fact, the Glucowatch website doesn't seem to have been updated in about a year. Hmmm. I wonder what's happening with them. I hope they get their shit together at some time, as the Glucowatch could be a really really useful tool.
My father has diebetes, and though immuno-depressing drugs do not sound so great, having his insulin level constantly in sync with his blood-sugar level should greatly help prevent diebetic complications (which are far worse than the daily dealings with the disease).
.
My father's daily routine is
1) measure his blood-sugar level (pricking the finger is the most accurate way to test)
2) injecting himself with the appropriate insulin amount.
However, there is a limit to how many times a day this can be done which results in stress to his system inbetween injections.
Though he is a type I diebetic, I certainly would not mind giving this treatment a shot even if his immune system would sabotage things in the end. I happen to live in Japan so it is not like I can complain about the treatment being too far from home . .
Where do I sign-up . . .
Sdelat' Ameriku velikoy Snova!
Diabetics learn very quickly how much insulin they require and to adjust it as they see fit.
On the insulin side, we have a wide range of available, from very rapid acting ( taking effect within 10 minutes to provide "bolus" (peak) insulin for when you eat) to very long acting (lasting up to 24 hours to provide "basal" (background) insulin). Using different insulins diabetics can get a remarkably precise control with little effort.
As for hypoglycemia (low blood sugar) leading to diabetic coma, this is easily avoided by any diabetic with even "rough" control due to the fact that they will readily feel blood sugar levels dropping far in advance of danger and a quick ingestion of some sweet substance will solve the problem in a matter of a couple of minutes - actually, it's quite remarkable how quickly the sugar is absorbed and works it's magic.
It's not hard these days to keep your diabetes in fair control, and within or close to the "normal" range that will keep problems later in life at bay. Diabetes is in essence a very treatable and predicatble ailment once detected.
Detecting it in the first place is probably the biggest problem these days - so many people don't recognize the symptoms...
a) Excessive thirst and urination - this is the biggie, classic and very telling symptom. Your body is working hard trying to flush itself, but it can't keep up.
b) Tiredness - the higher your BG gets, the more tired you get
c) Weight loss, dehydration.
d) Sweet fruity smell on the breath - your body is having to break down fats to get at sugars and as a result it's producing some pretty nasty by products - your getting keto acidosis. At this point you are extremely ill and must get to a doctor very quickly. I mean VERY quickly... if you delay then you may fall into a coma, your brain will swell, and rather soon, you will die.
People often leave it much to late, not getting diagnosed until they are in a state of acidosis - I know, I did - almost too late, but once diagnosed, a couple of days in a hospital and some home visits by a diabetes nurse educator I was fine - 10 years later I'm still fine, and I expect to still be fine for another 40 to 50 years at least.
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FYI I am a diabetic. I would rather take the risk of this transplanet then
A)Lose my feet
B) Go blind
C)Just let this disease slowly kill(heart/cardiovascular disease)
A endocrinologist told me that no matter how well you take care of yourself with this disease you will die of a complication(sparing a death by trauma). My whole life is taking care of this disease it a constant struggle. This is not a take your shot and you are fine disease it is slowly killing any one with it(Inslulin treatment is only slowing this). Oh and yes this procedure has been around for a few years but from what I've read the real cure would be stem cells/gene therapy at least for type one diabetics
You, and the parent both need to go see your endo. Really, you have some pretty lack lustre control going on there.
In 10 years I have *never* blacked out due to hypoglycemia, nor have I ever needed help to recover, if I did, then that would be a big wakeup call to get things back on track. And my control over the last 10 years is nothing to write home about.
I'd be interested to know what sort of insulin regime you are both on, and what lifestyles you have.
I have a very irregular lifestyle, I work for myself from home as a programmer and that means I'm constantly "changing shifts" I eat at widely different times, I sleep anything from 2 to 12 hours etc etc. yet still I manage to keep my Hba1c at 8% or so.
Living with diabetes shouldn't be a chore, it shouldn't even be hard. It sounds to me like your insulin regime is wrong for you both. I believe in the states there is some sort of fanatical devotion to "conventional therapy" where you have specific set amounts of insulin prescribed (self or otherwise) to take a specific times of the day, and must eat specific amounts of carb at specific times of the day etc.
What you should consider functional insulin therapy, where you use a long lasting insulin to provide a "basal" insulin dose (a "background"), and then when you eat a meal etc you take a rapid acting insulin to provide a "bolus" dose (or use a pump to handle both basal and bolus).
This allows you a much greater flexability with much less attention in my experience - no set dose, no set times, no set meals, everything is "played by ear" as to what you need at the time - which you will know from experience.
Whatever the case, you've only been diagnosed for a couple of years, and sounds like you might be teenage. If I can give you a some advice - don't worry about it so much - better to keep your BG higher than normal rather than end up hypo often, if you want to eat something sweet go for it, everybody needs something nice - just don't do it too often (and if you use a rapid acting insulin you can counter the effects of eating that custard tart, or fruit muffin every now and then).
Try and get away from "conventional" treatment schedules and go with a "functional insulin therapy", it is much more flexable, especially for young people who have irregular lives.
And go see your endo, you really need to get those blackouts knocked on the head.
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In Toronto there was a cell transplant without immune suppression.
I am also a physician, and there actually are quite a few cases in the literature of people who have stopped taking their immunosuppressives and not rejected their organs. It's not well-understood and there is no way to predict who can do this successfully, but it has happened. Also, the NIH sponspored Immune Tolerance Network has several clinical trials in the pipeline to prospectively test withdrawal of immunosuppressants (very possibly in islet transplant recipients, as it would not be a disaster if they rejected their organ as it would be with a heart, lung, etc.).
As a transplant patient, I have to say that I'm not aware of any anti-rejection drugs that are regularly injected. Certainly all my anti-rejection drugs are pills.
What people need to grasp though is that it's not TAKING the pills, it's what they do to you. I've been on them for close to three years, and I haven't had any major problems, but I could give you a list of minor ones. The most major I suppose was a period of anemia and leukopenia coupled with severe weight loss due to appetite loss. For that they had to test me for lymphoma and leukemia, and I'll tell you that a bone marrow biopsy is way worse than insulin injections. I also had to inject EPO to treat the anemia, but that was only once a week or so.
Transplants are a good road, but they are not the end of the road, and they are a treatment, not a cure. Certainly I hope that all this research will lead the way to better treatments, but for now I'm just glad to not be on dialysis.
I have seen the future, and it is inconvenient.
Hope this helps clarify.
Cheers!
Ok, what sucks about diabetes is having to take the injections
No. Trust me on this. What sucks about diabetes is the high likelyhood of losing your vision, pancreas, liver, feet, or even your dick.
A little jab in the stomache with a needle is nothing to fear compared to what high blood sugar does to your body over the long haul.
Information wants to be anthropomorphized.
Personally, I feel that the anti-rejection drugs are a lot more damaging than not. I'd rather stick with what works now. Insulin is cheap, and with the various types available, make it very easy to regulate and maintain blood glucose levels. Combined with a good blood glucose monitoring routine, and sensible diet/lifestyle choices, insulin can work very, very well. My last HBa1C was under 6.
As far as injections, (and I am currently doing 3 hits a day, 2 NPH, 1 NovoRapid), with the newer pen devices, and ultra fine needle tips, they are easy, and for the most part relatively painless.
I'd say that 98% of my shots I don't even really feel, and the other 2% simply serve to remind me that I'm diabetic.
Dr. Denise Fastman has reversed diabetes in mice
She's trying to raise money for human trials, but has run into a few bumps
While this is good news and all, there still have not been studies for the long term use of immusupressents. Being diabetic for over 30 years I keep up with this type of information. Dr Faustman, was the first to cure diabetes in long term non-obese mice. Type 1 diabetes is an auto immune disease. What Dr. Faustman did was to stop the auto immune disease and retrain the immune system. After the treatment, the insulin cells reproduce themselves and no more medication of any kind was needed. It's a two step process. She's now trying to raise 11 million for the first phase 1 trial on humans with the help of Lee Iaccoca (of Chrysler fame). Unfortunately, her process uses drugs who's patent has expired and hence not a lot money potential on something that already costs the United States over 100 Billion. Lee Iaccoca who has already donated over 20 million on diabetes research is spearheading raising money for this by going to the people. You can find out more information and donate (I have) at http://http//www.joinleenow.org
Several -years- ago, the CBC's Quirks & Quarks
(science program) announced the successful
Edmonton Protocol (transplanting islets from
healthy volunteers to Type 1 Diabetes sufferers).
Trials were conducted around the world (incl'g
Canada, USA & Sweden, to name a few locations)
with success rates into the 80 & 90% ranges.
Of course, the problem seemed to be rejection of
the islets. necessitating the need to reduce the
immune system's effectiveness in the recipient.
So, WHAT'S NEW HERE?!?
Doesn't this article's poster or
read medical journals before embracing articles?
Fair enough to let people know about treatments
just in case peoples' doctors aren't telling them
about them (what doctors or insulin-pump makers
want to lose business?)
But is this
Correct me if I'm wrong.
Next article, please.
I believe it is the first living doner transplant. There have been successful cadever transplants before. Whole organ pancreas transplants havent lasted. Islet cell extractions inject into the blood or liver (like bone marrow transplants) have been more successful.