Glucose-lowering drugs and insulin injections often struggle to maintain precise blood sugar control for those living with diabetes. - SCMP
BEIJING: Chinese scientists have reported the world’s first case of using cell transplants to treat type 1 diabetes.
The patient, a 25-year-old who had the chronic condition for over a decade, was able to naturally regulate her blood sugar some 2½ months after undergoing the minimally invasive surgery, Shanghai-based news outlet The Paper reported on Saturday.
According to the report, the surgery took just half an hour.
The team behind the breakthrough published their findings in the peer-reviewed journal Cell on Wednesday. Researchers from Tianjin First Central Hospital and Peking University were among those who took part in the study.
Diabetes is a major health threat worldwide. According to the International Diabetes Federation, China has the highest number of cases globally, with over 140 million patients and a prevalence rate exceeding 12 per cent.
The breakthrough cure converted these cells into personalized stem cells that were then used to grow clusters of fresh 'islets', hormone-producing cells in the pancreas and liver that help to regulate sugars in the body.
'I can eat sugar now,' said the 25-year-old, who lives in the city of Tianjing, where researchers say her body has successfully produced its own insulin for over a year.
The treatment, which outside experts have called stunning and 'wonderful,' builds on a related milestone in Shanghai in April.
That April case was different in that it involved transplanting stem cells into the liver, whereas the new method involved transplanting the newly made islets into the patient's upper abdomen near her pancreas.
Prior islet transplants into the liver have been harder to observe via noninvasive methods like MRI, experts said, making it harder to remove these cell-clusters in a worst case where a patient's immune system rejects and attacks the transplant.
This new method, inserting the islets just under the abdomen, allowed researchers to monitor the progress of these islets via MRI with comparative ease.
'They've completely reversed diabetes in the patient, who was requiring substantial amounts of insulin beforehand,' transplant surgeon Dr James Shapiro, who was not involved in the new study, told the journal Nature, approvingly.
Other independent experts joined Dr Shapiro, who serves as a medical researcher at the University of Alberta in Edmonton, Canada, in praising the breakthrough.
'If this is applicable to other patients, it's going to be wonderful,' diabetes researcher Daisuke Yabe of Japan's Kyoto University told reporters.
Some medical professionals, however, expressed caution over these results, waiting to see if the team's successful treatment can be reproduced in still more patients.
University of Miami endocrinologist Dr Jay Skyler, who specializes in type 1 diabetes, noted that he would prefer to see if this 25-year-old test patient continues to produce insulin for herself at least five years total, before considering her case truly 'cured.'
Health experts have generally also noted that the technique of crafting personalized transplants using the recipient's own cells is currently difficult to scale-up cost effectively — meaning the price tag for this diabetes cure could be staggeringly high in the early going.
The medical researchers at Nankai University and Peking University in China behind this new study noted that their test patient was already on immunosuppressant medication for a liver ailment.
Therefore it remains unclear if other patients' bodies might reject a transplant of similar islets derived from their own, personal extracted cells.
The June 2023 operation, as the team published in the journal Cell on Wednesday, took less than half an hour.
'The patient achieved sustained insulin independence starting 75 days post-transplantation,' as the Nankai and Peking University team wrote in Cell.
By the fourth month after her transplant, the 25-year-olds patient's total time in the desired or target blood sugar range leapt up from 43.18 percent to 96.21 percent.
Her so-called 'time-in-target glycemic range' has been above 98 percent, ever since, the researchers reported.
Medical experts have hoped that transplants like this — which subtly guide extracted patient's cells into becoming stem cells then used to grow more specialized cells for transplant back into the patient — might be less prone to rejection by the body.
The hope is that this method might override the need for immunosuppressant drugs, which help prevent transplant rejection at the cost of weakening a person's entire immune system.
Several groups, including private pharmaceutical companies, have started testing their own islet cell transplant treatments, also created using donor stem cells.
Vertex Pharmaceuticals in Boston, Massachusetts, with Dr Shapiro's assistance, has initiated a trial on a patient who also has type 1 diabetes, but is not prescribed with a regimen of immunosuppressant drugs.
'That trial is ongoing,' according to Dr Shapiro. - Agencies
