New hope for diabetes treatment

Stem cells are now being used in medicine for a variety of disorders. These cells have become a source of great hope for a significant number of diseases in the regenerative medicine realm. They are also helping in the development of new drugs to prevent and treat such chronic and difficult to treat conditions such as Diabetes, Parkinson's disease, spinal cord injury and Macular Degeneration.

Dr. Ian Rogers, a Scientist at the Samuel Lunenfeld Research Institute of Mount Sinai Hospital in Toronto, Canada, has been working on creating stem-cell based treatments for diabetes. He and his colleagues use stem cells to create natural replacements for essential cells in the pancreas that are destroyed by the illness, specifically in Type 1 diabetes.

For the past five years, Dr. Rogers has been focused on developing the regenerative capacity of umbilical cord and adult stem cells for clinical use, and making them a part of the future standard of care. His latest project involves developing induced pluripotent stem cells which have the ability to develop into many different types of cells from umbilical cord blood cells. Increasing the regenerative capacity of cord blood cells would extend their healing capacity beyond the blood diseases for which they are used currently.

For treatment of diabetes, the researchers differentiate stem cells into the critical cells of the pancreas that, in healthy people, measure blood sugar and produce the amount of insulin required to process it. These specialized cells would then be implanted in people with diabetes to reactivate the natural process.

At this stage, Dr. Rogers' team is building a pancreas out of a surgical sponge, in effect a three-dimensional structure seeded with insulin-producing islet cells. Ideally, the pancreas would be grown in the lab and then placed under the skin of a person with Type 1 diabetes to restore their insulin production.

This is a highly sophisticated procedure. The most advanced research project in his lab is much simpler: regenerating blood vessels so people with Type 2 diabetes who have damaged fingers and toes, (resulting from peripheral vascular disease) can avoid amputation.


So far the pancreatic stem cell technique has been studied in mice with promising results, although trials in humans are several years away. Lab studies have demonstrated that mice with a damaged pancreas can regulate their blood glucose levels within normal ranges with the transplanted cells. Coaxing the stem cells to develop into functional islets is not efficient enough to start clinical trials, but Dr. Rogers' group is now working to fix this problem.

It is known that stem cell transplants carry the risk of rejection or even possible tumour formation. To make the procedure safe, Dr. Rogers' lab is working to place the cells into porous bags that will allow the exchange of molecules between the cells and the body, but prevent the cells from escaping. This will also allow a physician to top up or replace the cells if they stop working.

The cells have shown no adverse side effects, hopefully demonstrating safety for future benefit in people with diabetes. If the procedure works, a patient's cell implants would require replacements every few years in an outpatient procedure, to counteract the body's natural immune response that slowly destroys them. Thus, instead of insulin injections, a patient would be using stem cell injections to augment his glucose levels. At first, the cells are expected to reduce the number of injections a patient requires. Eventually, as the procedure of generating islets becomes more efficient, the patient will be able to go for months or even years without having to inject insulin.

As the researchers note, there is considerable excitement of the potential for stem cell research but, ultimately, its value will only be realized if it can be applied to real medical needs. Dr. Rogers, like many other scientists around the world, is focused on developing this technology to ultimately benefit patients.

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