A World of Hope 1999
Diabetes Research Institute
Several hundred foolhardy souls braved hurricane Irene to venture to the Diabetes Research Institute in Miami, Florida to attend "A World of Hope 1999". It was worth the inconvenience of the hurricane.
At the DRI, we met with leading scientists involved in research into curing and preventing Type 1 diabetes. We also were given a tour of the DRI facility and were able to see the labs in which basic science and pre-clinical studies are conducted.
Monkeys Cured with anti-CD154Of particular interest was the presentation of Dr. Norma Sue Kenyon, who has cured non-human primates of diabetes through islet cell transplants in conjunction with a new drug called anti-CD154. These monkeys are made diabetic through the removal of their pancreases, so it is not a perfect model for autoimmune Type 1 diabetes.
Using poorly matched donor monkeys to ensure a good immune response, Dr. Kenyon isolates islet cells using equipment and techniques invented by Dr. Camillo Ricordi, the Stacy Joy Goodman Professor of Surgery and Medicine and Chief of the Division of Cellular Transplantation, at the University of Miami School of Medicine. The photograph to the right shows Dr. Kenyon holding one of the isolation chambers used in her experiments.
The recipient monkeys are then treated with anti-CD154 before, during, and after the islet transplant. This drug blocks a very specific pathway in the immune response to foreign tissue and has proven to protect the transplanted islets from rejection. Furthermore, the drug has proven that it can reverse a rejection episode and resturn an animal to normal blood sugars. The hope is that anti-CD154 will block not only rejection, but the underlying autoimmune attack of Type 1 diabetes.
Dr. Kenyon cautions that her work has been shown to work in monkeys that do not have autoimmune Type 1 diabetes and that "my daughter is not a monkey." By this she means that many therapies that cure small animals of autoimmune diabetes do not work in humans. Still, she remains excited at the potential for anti-CD154 to help transplanted islet cell survive without the need for highly toxic immunosuppressant therapy.
Immunobarriers and Tough Beta CellsDr. Christopher Newgard, Touchstone Chair in Diabetes Research and Professor of Biochemistry and Medicine at the Southwestern Medical Center in Dallas, Texas, presented an overview of his research into a novel immunobarrier and specially selected islet cells. Dr. Newgard's team, which includes private industry, has created a novel tubular immunobarrier that is inserted under the skin. There the hollow, curved tube (roughly shaped like a "U" in which the tops touch) is left for several weeks, during which the body grows blood vessels on the device. Once vascularized, a small incision is made and a smaller tube, this one containing special islet cells, is inserted.
Dr. Newgard's team uses genetically engineered islet cells that are grown in culture and are specially bred to withstand the immune attack associated with cytokines and free radicals. These "toughened up" islet cells are then better able to survive. Testing is thus far limited to small animals.
Dr. Norma Sue Kenyon holds an islet cell isolation chamber, invented by Dr. Camillo Ricordi. These chambers were used by Dr. Kenyon in her ground-breaking research that cured non-human primates of diabetes. While encouraged by this work, Dr. Kenyon, who has a young daughter with Type 1, cautions that "my daughter is not a monkey."
Clusters of islets isolated using the system developed by Dr. Ricordi. These islets are then used for transplantation. Click for a larger photo. Image courtesy of the Diabetes Research Institute.
Dr. Christopher Newgard and Dr. Gordon Weir with Al Gordon of the Islet Foundation. Dr. Newgard is exploring a novel islet cell encapsulation technique, along with a method of producing islet cells that withstand the autoimmune attack. Dr. Weir is Professor of Medicine at the Harvard Medical School and Associate Director, Diabetes and Endocrinology Research Center at the Joslin Diabetes Center. Al Gordon runs The Islet Foundation.
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Posted October 17, 1999
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