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Type 1 diabetes and stem cell therapy

Diabetes is characterized by abnormally high levels of the sugar glucose in the blood stream; it is actually a group of diseases. This complicated disease is caused by destruction of islet cells of the pancreas by patient's on immune system. Body's immune system is not able to identify the cells of the body and sees them as foreign. Due to unavailability of insulin, glucose cannot enter the cell and glucose accumulates in the blood. Most of the complications of diabetes, which include blindness, kidney failure, heart disease, stroke, neuropathy, and amputations, are caused by this excess glucose. More deaths are resulted by diabetes alone every year compared to breast cancer and AIDs combined.

Type 1 diabetes is also known as juvenile-onset diabetes and it typically affects children and young adults. Treatment for type 1 diabetes is a lifelong regime of taking insulin, exercising regularly and maintaining a healthy weight, eating healthy foods, monitoring blood sugar. The primary aim is to keep the blood sugar level as close to normal as possible to delay or prevent complications.

There is currently no cure for diabetes. There is a dearth of effective therapies in spite of the major progress in understanding the underlying disease mechanisms for diabetes. For years investigators have been making slow, but steady, progress on experimental strategies for pancreatic transplantation and islet cell replacement. Now, researchers have turned their attention to adult stem cells that appear to be precursors to islet cells and embryonic stem cells that produce insulin. s

Treatment options:

  • Pancreas transplant: A successful pancreas transplant eliminates the need of insulin. The procedure poses serious risks and to prevent the body from rejecting the transplanted pancreas, patient needs a lifetime of potent immune-suppressing drugs. These drugs can have serious side effects, including a high risk of infection and organ injury. The side effects of the transplant can be more dangerous than the diabetes, and so it is usually done in patients going for either kidney transplant also or is generally reserved for those with very difficult-to-control diabetes.
  • Islet cell transplantation: Researchers are experimenting with islet cell transplantation, in which they attempt to cure diabetes by injecting patients with pancreatic islet cells-the cells of the pancreas that secrete insulin and other hormones. Thus the host is provided with new insulin-producing cells from a donor pancreas. Steroid immunosuppressant therapy is required to prevent rejection of the cells, this in turn increases the metabolic demand on insulin-producing cells and eventually they may exhaust their capacity to produce insulin. The harmful effect of steroids is greater for islet cell transplants than for whole-organ transplants. The demand is high and because of the shortage of organ donors, these requirements are difficult to meet. Further, islet cell transplant recipients as all ready mentioned have to follow a lifetime of immunosuppressant therapy, which makes them susceptible to other serious infections and diseases.

Stem cell transplant:

In a new study, patients were able to stop using insulin on being provided with stem cell therapy. The stem cells were sourced from their own blood. Also these people were newly diagnosed with type 1 diabetes. Stem cell transplants involve shutting down the immune system and then building it up again. The technique has the potential of providing treatment option for type 1 diabetes. In designing of stem cell therapy for patients with diabetes, researchers hope to develop a system that meets several criteria.

Fetal Tissue as Source for Islet Cells

Investigation for the use of fetal tissue as a potential source of islet progenitor cells, is underway and it has been found that insulin content was initially higher in the fresh tissue and purified islets ( n being sourced from fresh human fetal pancreatic tissue, purified human islets, and cultured islet tissue). The cultured islets when implanted showed increase in insulin content over the course of three months. It was also concluded that within the cultured islets the precursor cells continued to replicate and differentiate into functioning islet tissue. On the other hand, the purified islet cells (already differentiated) could not further proliferate when grafted.

Adult Tissue as Source for Islet Cells

Islet cells from human adult cadavers have also been cultured for use in developing transplantable material. And the researchers have been successful in engineering stem cells to proliferate and culture, specifically in case of diabetes. Islet ells isolated from human cadavers have been engineered by adding to the cells' DNA special genes that stimulate cell proliferation. And on further engineering, such cells have been shown to

Future Directions

In treating diabetes, researchers need to overcome the autoimmunity, which causes diabetes. Many safety issues must be addressed, before any cell-based therapy is undertaken to treat diabetes. Embryonic stem cells show the greatest promise for generating cell lines that will be free of contaminants and that can self renew. However, most researchers agree that until a therapeutically useful source of human islet cells is developed, all avenues of research should be exhaustively investigated, including both adult and embryonic sources of tissue. Though undoubtedly, stem cell therapy seems to be only light at the end of the tunnel for diabetic patients.

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