Chinese scientists have managed to reverse type 1 diabetes in a patient thanks to a stem cell transplant, marking a significant advance in the treatment of this disease.
“I can finally eat sugar,” said the patient from Tianjin, China, to Nature. The 25-year-old woman became the first person in the world to be cured of type 1 diabetes thanks to a transplant of her own stem cells.
This world first raises hopes of developing a treatment for this autoimmune disease, usually considered irreversible: type 1 diabetes can be managed with an intake of exogenous insulin, but not cured.
To achieve this scientific feat, Deng Hongkui, a cell biologist at Peking University, and his colleagues extracted cells from three people with type 1 diabetes and reverted them to a pluripotent state, meaning they could be transformed into any type of cell in the body.
The researchers then used the chemically induced pluripotent stem (iPS) cells to generate 3D clusters of islets: islets are groups of three types of endocrine cells scattered throughout the pancreas.
They tested the cells for safety and efficacy in mice and non-human primates, before injecting them into the patient’s abdominal muscles. Most islet transplants are injected into the liver, where the cells cannot be seen. But by placing them in the abdomen, the researchers could monitor the cells using magnetic resonance imaging and potentially remove them if necessary.
The implanted cells began producing insulin on their own, effectively restoring pancreatic function. Over time, the patient experienced improved blood sugar levels and significantly reduced reliance on insulin injections.
The study, published September 26 in Cell, follows another study by scientists at Shanghai University in China, which reported successfully transplanting insulin-producing islets into the liver of a 59-year-old man with type 2 diabetes in April. The islets also came from reprogrammed stem cells taken from the man’s own body, and he has since stopped taking insulin.
Half a billion people worldwide suffer from diabetes
The studies are part of a series of pioneering trials using stem cells to treat diabetes, which affects nearly half a billion people worldwide.
Most of them have type 2 diabetes: the body does not produce enough insulin or its ability to use the hormone is reduced. In many cases, it is possible to delay or prevent the onset of the disease. Accounting for about 90% of all diabetes cases, type 2 diabetes is the most common type of diabetes. Changes in diet and physical activity related to rapid development and urbanization have led to a sharp increase in the number of people with type 2 diabetes. Previously, the condition mainly affected the elderly. However, due to increasing obesity, sedentary lifestyles and poor diet, type 2 diabetes is increasing among children, adolescents and young adults.
In type 1 diabetes, the immune system attacks the islet cells of the pancreas. People with type 1 diabetes need daily insulin injections to control their blood sugar. If they don’t have access to insulin, they will die. The exact causes of type 1 diabetes remain unknown. However, research shows that the chance of developing the disease increases slightly if a family member has it. There are also environmental factors, such as exposure to a viral infection, that can trigger an autoimmune reaction that leads to type 1 diabetes.
Stem cells can be used to grow any tissue in the body and can be grown indefinitely in the lab, meaning they potentially offer an unlimited source of pancreatic tissue. By using tissue made from a person’s own cells, researchers also hope to avoid the need for immunosuppressants, which must be taken during a cell or organ transplant from donors to prevent rejection.
Although the initial results are promising, this approach is still in the clinical trial phase and much more in-depth research is needed to assess its long-term effectiveness and safety. The team of scientists indicated that the results are equally encouraging for the two other patients treated in this clinical trial. They now hope to be able to extend it to 10 or 20 other individuals. This will be an essential step to confirm the proper functioning of the procedure and convince the scientific community.
