A revolutionary transplant allows a diabetic patient to regain the ability to produce insulin

Scientists at Nankai University (China) have made a significant breakthrough in the treatment of type 1 diabetes, transforming fat cells into insulin-producing beta cells

Genetic, environmental and lifestyle factors have triggered the incidence of metabolic diseases, considered by many to be the pandemic of the 21st century. These pathologies affect the functioning of the metabolism, the set of processes responsible for transforming nutrients into energy.

Among the best known and most widespread is the diabetes, which manifests itself in various ways. The one of Type 1 It occurs when the immune system attacks the beta cells of the pancreas, which are responsible for producing insulin. insulin, the body cannot use sugar as an energy source, forcing patients to obtain this key hormone externally for life.

But a new window of hope has just opened in the fight against type 1 diabetes: recently, a transplant has allowed a patient to produce his own insulin again.

A sophisticated cellular programming

The authors of the advance are scientists from the Nankai University, China. As published in the magazine CellThey first obtained fat cells, specifically adipocytes, from a 25-year-old woman with type 1 diabetes. They then converted them through a cellular reprogramming process into induced pluripotent stem cells (iPSCs); that is, those capable of transforming into any type of cell.

from these iPSC, Chinese scientists generated insulin-producing beta cells and eventually transplanted them into the patient's abdominal muscle.

It is worth noting that all cell reprogramming processes were carried out with chemicals, which makes it possible to dispense with biological tools such as genetic editing and its associated risks. Another great advantage is that, being a autotransplant, there is no risk of rejection by the immune system, unlike conventional transplants.

Data must be taken with caution

The first data after the intervention are very promising: After two and a half months, the patient no longer needed to continue her insulin treatment., becoming insulin-independent. In addition, their blood glucose levels were comparable to those of a non-diabetic person.

However, there is a possibility that the autoimmune response characteristic of type 1 diabetes may be reactivated and destroy the implant. But this is something that we cannot verify in this case, since the patient was immunosuppressed due to a previous liver disease. The results must therefore be taken with caution.

Another important aspect that remains to be evaluated is whether this technique, if proven effective in the long term, would be viable on a large scale. The cost and complexity of the procedure could hamper its development as a widespread cure for the nearly 50 million people worldwide who suffer from type 1 diabetes.

Medical revolution underway

A similar strategy to the one mentioned was also used this year in China to treat type 2 diabetes. In that case, the patient recovered normal glucose levels prior to the development of the disease two years after the transplant.

In addition, Vertex Pharmaceuticals is testing insulin-producing cell transplants obtained from embryonic stem cells—rather than from the patient's own cells—in people with type 1 diabetes. Although the results have not yet been published in scientific journals, press releases indicate that some patients who have undergone the procedure have achieved insulin independence.

The problem is that these patients require severe immunosuppression, which has led to complications. In fact, it has been reported that two of the people treated (and apparently cured) died. The company has not given details about the causes.

To address the immune rejection problems, one of Vertex’s clinical trials, uses an experimental technique that encapsulates insulin-producing cells in plastic nanocapsules designed to protect them from immune response. So far, no conclusive data have been published on the effectiveness of this approach.

Only time will tell whether stem cells can live up to their promise or whether they are just empty promises.

Source: The Conversation