manufacture highly effective human islets
Getting highly effective pancreatic islets is a priority objective in transplants, since organs can be better used.Antonio Cuesta has presented his work in this field in the ADA.
Two years ago, Antonio Cuesta, director of the Center for the Study of Beta-Pancreatic Cell Diseases of the Imabis-Foundation Carlos Haya, from Malaga, showed that there are highly effective pancreatic islets.The case of a girl with severe neonatal hypoglycemia associated with a mutation of glucocinase, the V91L, was published in The New England Journal of Medicine (see DM of 8-IV-2010).
The Cuesta Group has continued with this line of work and has now shown that highly effective islets can occur with genetic engineering and has presented it at the LXXII meeting of the American Diabetes Association, which has been held in Philadelphia.
As explained by Journal Medical, they have been able to replicate in humans with genetic engineering what they had already found in Animal Model."We have worked with the glucocinase mutation that we saw in the patient, the V91L, and we have introduced it with a vector, in this case we use a lentivirus, with the idea of replicating the powerful islets we find in that patient."
Good results
Cuesta is satisfied because they have been able to reproduce it, which has deserved to be the only Spanish who has participated in a session as a speaker within the aforementioned American meeting.
In the work it has been proven that these islets, in addition to producing more insulin, are also able to regenerate, which will be very useful for pancreas transplant."Now two pancreas need to be isolated to treat a patient, since with the transplant the disease is not cured, it is."
For this approach, two pancreas are required, of which the islets are isolated and are the ones that are transplanted."For now, the function is restricted to five years, and the patient remains insulin independent that period of time."
The hypothesis with which it works is to see if they are able to make those most efficient islets and thus, instead of using 600,000 islets, which is what is needed and obtained from two pancreas, with 20,000 islets a patient could be treated."From each pancreas an average of 300,000 islets is extracted; considering the loss of islets that may be in the process, initially with a pancreas, five patients could be treated."
Regeneration
The researcher recalled that the islets are not regenerated in the adult pancreas."In the human being, it is regenerated only in the first years of life, and from the age of four the replication capacity is lost."
Cuesta has worked with adult islets, who lose the ability to regeneration, and has proven that they can be regenerated.In fact, he says that it has already been demonstrated in humans: the patient with hypoglycemia with mutation in the V91L has lived for seven years with 20,000 islets and normaglucemic.
"To have a normal pancreatic function, an average of one million islets is needed, but our patient has been able to live with the 20,000 activated islets."
Now we have to study if the same thing happens to the girl and get normoglycemia.He recalled that apoptosis occurs, which runs the risk of diabetics at five years."If you can solve with 20,000 islets and be insulin -dependent for five years is a good option, since you can repeat how many times you want."
The risk that the vector can raise is void, "since it is shown that no problems occur; what we do have to study is immunosuppression, but it is similar to any transplant"
