Islets of hope
Why cell therapies are finally taking off in Type I diabetes
The idea of using islet cell transplantation to treat diabetes has been simmering on the back burner for the last 15 years, with progress limited by two key obstacles: a shortage of donor cells, and a high chance of an immune attack on the transplant. But a series of incremental advances, a major leap forward, and emerging technologies from orthogonal disciplines have injected new energy into the field, which may be poised to provide the first long-term treatment or even cure for Type I diabetes.
For almost 100 years, the standard of care for the disease has been glucose monitoring and management with insulin injection, but for almost as long, researchers have been looking for an easier, more accurate way to control glucose levels.
The quest has centered on replacing the β cells that are lost to autoimmune destruction, because those cells both monitor changes in blood sugar levels and respond by producing the right amount of insulin.
"People talk about the fact that β cells produce insulin, but they also read glucose levels every millisecond," said Douglas Melton, professor and co-chair of the Department of Stem Cell and Regenerative Biology at Harvard University, and co-director of the Harvard Stem Cell Institute.
"Patients who inject insulin may measure their glucose levels every few hours. I can't overstate how much of a big improvement in control a cell therapy could offer patients," he told BioCentury.
Despite more than 25 years of evidence that a single transfusion of donor cells has the potential to control glucose levels in Type I diabetes, the technology has yet to make an impact on