By modifying the procedure for islet cell transplantation, researchers at University of Illinois, Chicago, have achieved insulin independence in diabetes patients with fewer but better-functioning pancreatic islet cells.
UIC is one of only a few centres around the world that successfully achieved reproducible and consistent insulin independence in severe type 1 diabetes patients.
In this study, the researchers provided 10 diabetic patients between one and three islet cell transplants and followed them for 15 months. Also, 4 such patients received the Edmonton protocol, developed at the University of Alberta, which uses a combination of two immunosuppressants and a monoclonal antibody drug, daclizumab.
In addition, 6 patients received the UIC protocol, a combination of etanercept (an anti-inflammatory drug developed to treat rheumatoid arthritis) and exenatide (a drug approved for use in type 2 diabetes to improve glucose control), and the Edmonton regimen.
According to Dr. Jose Oberholzer, director of cell and pancreas transplantation at UIC and lead author of the study, this new method allowed patients to get off insulin after a single transplant unlike the two to four transplants that were needed using the older protocol.
Every patient in the study achieved insulin independence, but those who received the UIC protocol required less than half the number of islets as those who were treated under the Edmonton protocol. Also, the 4 patients who received the Edmonton protocol needed either two or three sequential islet cell transplants to achieve insulin-independence.
The 6 patients who were treated with the UIC protocol achieved insulin-independence initially after only one islet transplant. Two of these patients required a second islet cell transplant, and one resumed insulin five months after the second transplant due to other complications.
Oberholzer, associate professor of surgery, bioengineering and endocrinology at UIC, said that islet cell transplantation progress has been limited by the shortage of donor organs.
"This study is extremely promising and shows that we can achieve success with fewer islet cells, freeing patients from the need to check their insulin, even after 20 or 30 years of suffering from diabetes," he said.
The study results are published in the latest issue of the American Journal of Transplantation.