A new transplant technique has enabled eight diabetic patients to completely stop their insulin injections. The study, described this morning at the meeting Transplant 00 in Chicago, is "truly a milestone in the treatment of diabetes," said Hugh Auchincloss transplant surgeon at Harvard Medical School.
Type I or childhood onset, diabetes affects hundreds of thousands of people in the United States is believed to start when the immune system kills insulin-producing cells in the pancreas. insulin plays a key role in regulating the blood glucose by promoting the conversion of sugar into glycogen. to compensate for the lost cells, diabetics must inject insulin several shots a day. Even with these injections, however, wide variations in the levels of sugar in the blood trigger side effects ranging from kidney failure and nerve damage to blindness.
for years, researchers have sought ways to transplant cells producing healthy insulin in diabetic patients. Most were only partially; patients less than one in 10 can do without insulin injections one year after the transplant, and they all have to endure the side effects of immunosuppressive drugs.
A new protocol developed by transplant surgeons James Shapiro, Jonathan Lakey, and colleagues from the University of Alberta in Edmonton, Canada, has had much better initial results. The eight team patients - one of them treated there more than a year -. Have normal blood sugar without insulin injections
The team attributes the success to several factors. First, they transplanted islet cells as soon as possible after the removal of an organ donor. Second, do not use any non-human proteins for preparing the cells prior to transplant. Finally, they used a new anti-rejection drug that blocks a protein CD25 specific immune system, instead of steroid drugs used commonly. These drugs are known to be hard on the pancreatic cells, says immunologist transplant Norma Kenyon of the University of Miami in Florida, but the cells seem to tolerate the new drug more easily.
Kenyon warns that patients who are age 29-53, must remain on immunosuppressive drugs for the rest of their lives. Auchincloss and stresses that each graft requires two donor pancreases, so that the treatment would only be available for "a small fraction" of diabetics. To help more patients, researchers will learn how to grow human islet cells in culture or to find a way to use animal islets. The protocol is "a really great step," Auchincloss said. "But is was only a step. It is actually not the cure. "
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