Hope for diabetics as stem cells turned into insulin-producing cells

Hope for diabetics as scientists turn stem cells into insulin-producing cells in medical breakthrough that could ‘finally find a cure’

• Researchers created healthy beta cells, which are destroyed in type 1 diabetics
• Cells produced insulin and responded to blood sugar within days in mice tests
• It’s a step forward in the long studied treatment of cell transplantation  

Stem cells have been turned into insulin-producing cells in a medical breakthrough for the treatment of type 1 diabetes.

Researchers have for years tried to figure out how to make the transformation in the hope of helping millions battling the condition.

Now, they created functioning healthy beta cells – which are destroyed in a type 1 diabetic’s body – in a petri dish. 

After transplanting them into mice, the cells began to produce insulin and respond to blood sugar within days. 

It has the potential of ‘finally finding a cure’ to type 1 diabetes, which strikes around 1.25million in the US and 400,000 in Britain.

Scientists believe they may ‘finally find a cure’ for type 1 diabetics after managing to create functioning healthy beta cells from stem cells, which produced insulin in mice 

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin due to the immune system attacking the cells.

In a small number of cases, diabetics can have a pancreas transplant but there is limited availability.

Transplants of just the pancreatic ‘islets’ – clusters of cells containing healthy beta cells – are currently in clinical trials, but still rely on pancreases from deceased donors. 

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Therefore, scientists have been working to figure out how to program stem cells into functioning beta cells for years – but have faced obstacles. 

WHAT IS A PANCREAS OR ISLET TRANSPLANT?  

A pancreas transplant is usually only considered in a small number of cases of people with type 1 diabetes.

There are around a million people in the UK with type 1 diabetes, but only about 200 get a pancreas transplant each year.

Type 1 diabetes occurs when the immune system destroys the cells (islets) in the pancreas that produce a hormone called insulin.

It can often be controlled with insulin injections, so the risks of a pancreas transplant outweigh the benefits in many cases.

It may be several months, or possibly years, before a suitable donor pancreas becomes available.

In the UK, half of the people waiting for a pancreas transplant will have had one by around 13 months.

A small number of people with type 1 diabetes may have a slightly different procedure, called islet transplantation, where only the cells that produce insulin (islet cells) are transplanted from a donor pancreas into the liver. 

A thin, flexible tube (catheter) is inserted through your tummy and liver, into the vein that supplies the liver with blood. The donor islet cells are then injected into it.

If the procedure is successful, the donor cells will start making insulin. This can help people who experience severe episodes of a dangerously low blood sugar level (hypoglycaemia) that occur without warning.

Insulin treatment is often still needed after the operation, but the episodes of hypoglycaemia should be easier to control.

Source: NHS  

Dr Matthias Hebrok, senior author of the study at University of California San Francisco (UCSF), said: ‘The cells we and others were producing were getting stuck at an immature stage where they weren’t able to respond adequately to blood glucose and secrete insulin properly. 

‘It has been a major bottleneck for the field.’

The team, led by Dr Gopika Nair, instead looked at the physical process by which the cells separate from the rest of the pancreas and form the so-called islets of Langerhans.

It was the formation of this islet that appeared to be important, rather than the individual cells themselves. 

Dr Nair said: ‘A key principle in biology is that form follows function, so we reasoned that the formation of islets might be an important process for beta cells to mature properly.’

The researchers replicated the process in lab dishes by artificially separating partially differentiated pancreatic stem cells.

They then reformed them into islet-like clusters and the cells’ development suddenly leapt forward.

The researchers then transplanted these lab-grown ‘islets’ into healthy mice and found that they were functional in three days and produced insulin in response to blood sugar.

Dr Hebrok said: ‘We can now generate insulin-producing cells that look and act a lot like the pancreatic beta cells you and I have in our bodies. 

‘This is a critical step towards our goal of creating cells that could be transplanted into patients with diabetes.’

The findings, published in Nature Cell Biology, shed hope on new treatments for diabetics that don’t rely on donors.

Dr Nair said:  ‘Current therapeutics like insulin injections only treat the symptoms of the disease. Our work points to several exciting avenues to finally finding a cure.’

Diabetics can manage their disease, but are at risk of serious health complications including kidney failure, heart disease and stroke.

Patients may be eligible for a pancreas transplant from a deceased donor if they also have severe kidney disease, or if they have severe episodes of a dangerously low blood sugar level (hypoglycaemia) that occur without warning, in spite of good insulin control. 

But transplants are rare and the waiting list is a long time – only about 1,000 US type 1 diabetics get pancreas transplants in any given year, and 200 in the UK.  

The procedure is also very risky, and recipients must take immune-suppressing drugs for life, which can put them at greater risk of infection.   

Dr Hebrok said: ‘We’re finally able to move forward on a number of different fronts that were previously closed to us. The possibilities seem endless.’

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