Home |  Elder Rights |  Health |  Pension Watch |  Rural Aging |  Armed Conflict |  Aging Watch at the UN  

Mission  |  Contact Us  |  Internships  |  Donate Now!  

back

Doctors expect the next decade to bring a revolution in treatment options for the 30,000 people who develop new cases of diabetes every year in the United States.

They foresee these patients moving beyond the rigors of insulin therapy, pancreas transplants, and even the current focus of research -- transplantation of insulin-producing islet cells.

If researchers, including a new initiative at the University of Miami, succeed, cells that can make insulin, which converts food into energy, will be produced in the lab from readily available stem cells, ending diabetics' wait for rare donor organs.

Parallel research seeks the secrets to preventing the body's rejection of transplanted organs and cells, freeing recipients from the dangers of antirejection drugs.

``If we can advance this, it will be the treatment of choice,'' said Dr. Juan Dominguez-Bendala, recently recruited by UM's Diabetes Research Institute from the Roslin Institute in Scotland, famous for cloning Dolly the sheep. ``Hopefully it will get us closer to curing diabetes within 10 to 15 years.''

The potential for stem cells, the early cells that can turn into any type of tissue, to cure disease and restore the function of damaged organs was hailed by university researchers and biomedical industry representatives at a conference this week of UM's new Cellular Therapies and Tissue Engineering Initiative.

Cancer physicians, transplant surgeons, spinal cord injury researchers and others are joining the diabetes team to discover how replacement tissues might be manufactured, in many cases using adult stem cells from muscles, skin, even fat.

``This is not an ivory tower kind of initiative,'' said Dr. Camillo Ricordi, scientific director of the Diabetes Research Institute and director of the new initiative. ``It has potential application in a lot of degenerative diseases.

``We want to speed up the path of university discoveries from the bench to the bedside.''

In the case of Type I diabetes, the most serious form, pancreas transplant is an extremely limited option: Only 1,300 are performed each year, reaching a tiny percentage of the patients who might benefit.

The transplantation of islet cells, pioneered years ago at the DRI, has received lots of attention recently because of the success of what's known as the Edmonton Protocol in keeping diabetics off insulin. The DRI is participating in trials of the protocol, which will be even more limited because it takes cells from two donor pancreases for each patient.

Hence the enthusiasm for finding new sources of insulin-producing cells. Scientists are first trying to figure out, using mice, how the pancreas develops and what mechanisms cause some cells to become islet cells.

``The hope is that once we can understand that, we can basically recapitulate those very events starting with other cells and teach them to become pancreatic islets,'' said Dr. Luca Inverardi, UM professor of medicine, microbiology and immunology.

Several sources for those other cells are being studied. Researchers are working with embryonic stem cells from mice and adult stem cells from various human tissues -- including fat.

``The idea of having such easy access to these precious cells is quite remarkable,'' Inverardi said. ``It would make this access a clinical reality without the need of any type of invasive procedure.''

Scientists would prefer to build replacement tissue using the recipient's own stem cells. ``This is the ideal scenario, the perfect goal that we have with this research,'' Inverardi said.

Central to the DRI's research on islet cell development is a new lab under the direction of Swedish investigator Helena Edlund, a world leader in the field.

Reeducating the immune system to accept transplanted cells or organs is also a major goal. ``Even if we were able to obtain enough islets today, they would not be a perfect cure, because the body would attack them,'' Inverardi said.

Now recipients are given lifelong antirejection drugs, which can cause other complications including cancer and infection. Researchers are pursuing several approaches to inducing what they call tolerance of the donated organ or cells.

The tissue engineering initiative, which pulls together the work of more than 60 researchers, was designed in large part to help UM compete for more of the growing pool of research funding from the federal government and industry. The co-director is Dr. Herman Cheung, professor in the schools of medicine and engineering.

.