{'en': '"We are doing clinical trials on type 1 diabetes that were science fiction for a few years"', 'es': '"Estamos haciendo ensayos clínicos sobre la diabetes tipo 1 que hace unos años eran ciencia ficción"'} Image

"We are doing clinical trials on type 1 diabetes that were science fiction for a few years"

  
fer
01/10/2018 9:11 a.m.

Juan Domínguez Bendala leads the research on diabetes from the Diabetes Research Institute of Miami, worldwide reference center in the development of cellular therapies for diabetes.

This Sevillian, that whenever he can, return to the Andalusian capital, "and bring my children not to lose their roots."Although in Miami he lives very comfortable, "it is not a city like Seville or Edinburgh (where he studied many years and was a doctorate), in which you find friends on the street."

Juan Domínguez Bendala was marked by Edimburg and working with one of the parents of the Dolly sheep, "an unforgettable experience" and source of inspiration to write 'The Rodson's deer', "an adventure novel, written with a lot of humorset in the nineteenth century.

The protagonists are scientific, aristocrats, very well paid from himself who wantA surrealist plot, "as Robson's deer is only generated once every 600 years and is the result of the crossing of two creatures living in very different places such as Alaska and California and if they manage to cross, the female puts an egg that is practically invisible"

A written book, "in my free time. In Miami, it took 45 minutes to get to work and written at that time, on the train and when I had no children, it would now be impossible."Book that is a void jump for someone who has written a lot, "I have always liked writing", but about cells and diabetes type 1.

Type 1 diabetes that "is a devastating disease, is known as youth diabetes because it affects most young children and people, and there is no cure for this disease, these patients depend on insulin to survive. For some time we have been pioneers withA procedure in which we transplant cells from a body to diabetic patients and we have managed to make diabetics of a lifetime do not have to take insulin anymore, but we do not have enough organs to benefit the number of patients.

Now we have been working on a project in which there would be no need to transplant the cells but we have discovered some stem cells within the patient's pacreas that we can stimulate without transplanting them and they give rise to new cells that produce insulin, and this would be aGreat revolution because we would have the opportunity to restore the cell that has been lost as a result of the autoimmune attack in a diabetic patient.

If we have success we still have to wait to see if we can stop the autoimmune response because the autoimmune system is with the idea of ​​killing the new cell and we are working with immunologists to get it, "explains Dr. Domínguez Bendala that as every scientist refuses to give dates"I can't give a date, but we are doing clinical trials that a few years ago was science fiction."

Essays that place us in "the least bad moment to diagnose a child to a child, maybe in five, ten years a device is put on the back and you should not go to the hospital in six months to move the deviceIt is not a cure, but any patient of today would sign a therapy like this. "

the article that changed its future

When he turned 17, he ran into a report on Scottish scientists who had genetically modified a sheep to produce a human protein in milk.This protein was essential for the treatment of AAD patients, a serious lung disease.It was enough to milked these sheep to obtain industrial amounts of the medication."At that time I decided to continue in that direction."He enrolled in biology at the University of Seville and, thanks to the support of his parents, after performing military service in university militias, he could continue his training in London, where he enrolled in a master's degree in molecular biology and biotechnology in 1995. ThatIt was the first time that he left Seville to live abroad, an experience that expanded his horizons.“At first it was difficult, but I was finally able to overcome the inertia and fear of many Sevillians of my generation to go abroad.London opened many doors to me.Part of my master's thesis was an external project, which I completed in the prestigious Roslin Institute near Edinburgh.At the precise moment in which I made my bags there, this institution was in the headlines of all the newspapers in the world for having cloned the first mammal in history, the Dolly sheep.Interestingly, adjacent to this institute was the PPL pharmaceutical company, where they had created that other transgenic sheep that had consolidated my vocation ten years ago. ”

When he finished his master's project, he was the opportunity to study the doctorate under the supervision, precisely from one of Dolly's creators.I would have returned to Spain but the opportunity, he remembers, was too good to let it pass.The unconditional support of her family and the woman who was then her girlfriend (and with whom she is married today) did the rest.In 2000 he completed the project, a thesis on the genetic manipulation of embryonic stem cells.“At that time I contacted the directors of the Diabetes Research Institute (DRI) of the University of Miami, and offered my candidacy to start a new program in order to use stem cells in the treatment of youth diabetes (type 1).In my decision to contact the DRI, not only his prestige weighed but the circumstance that who would end up being my wife already lived in Miami. ”

At that time, human embryonic stem cells had just been developed (just two years ago, in 1998) and their group in Scotland had been one of the first worldwide to study them.From his words it follows that this temporary coincidence, the fate or opportunity of events, were related to the development of their career, but not only: “Many lucky circumstances were aligned.The DRI was at the same time planning the creation of a pancreatic regeneration laboratory.The field of regenerative medicine was in its dawn, and I came from the very cradle.They offered me a postdoctoral position and accepted it.From there I began to grow professionally within the institute, directing my own group since 2004. ”

The advance of stem cells

The institutional mission of the DRI is to find a cure for type 1 diabetes in the fastest, efficient and safe way possible.It is, the doctor expands, a complex and different disease from the most prevalent diabetes (type 2), since there is an autoimmune component.

Q.- How do this type of diabetes stop in the DRI?
R.- The patient's immune system recognizes insulin producing cells, and eliminates them.To cure type 1 diabetes, a multidisciplinary team is needed, and the DRI is organized to investigate every aspect of the disease in an integrated way.Almost everything we do orbits around a pioneering treatment developed almost 30 years ago by our scientists, the islet transplant.The islets are small structures in the pancreas that contain beta cells, which produce insulin.When the pancreas of a deceased donor arrives, we can extract these cells (just 1-2% of the total mass of the pancreas), purify and transplant them in diabetes patients.HeProcedure is simple and does not last more than 20-30 minutes.Of course, to avoid the rejection of these transplanted cells, the patient must take anti-recreational medications for the rest of his life.However, not having to depend on insulin injections to survive has radically changed the lives of hundreds of transplanted patients.

Q.- What role will stem cells play in the fight against this problem?
R.- The limitations of the process are clear.First, due to the need for immunosuppression;and second, for the shortage of organs to transplant.In the United States alone there are three million people with type 1. diabetes. In the last decade we have been able to transplant islets to less than 2,000 patients worldwide.In my laboratory we are trying to solve this second problem through the use of stem cells.We can induce the unlimited reproduction of these cells and, when we have enough, to "educate them" to become insulin producing cells.Clinical trials are already being done (phase 1 and 2) with embryonic stem cells for type 1 diabetes. If they succeed, in a few years we will be able to treat millions of patients.

Q.- Are they more difficult to generate the cells that provide insulin?
A.- That's right.If you let the embryonic stem cells "choose your own destiny, most will become neurons or cardiac tissue.But generating beta cells from stem cells is a long, inefficient and laborious process, during which the cells must be forced daily to make certain decisions and not others.For example, in the middle of the process, it is almost more important to block the conversion to the liver than add signals that favor conversion into pancreas.

Q.- Why will the number of people with diabetes increase in the coming years?
A.- Type 2 diabetes is associated with sedentary lifestyle and obesity, two trends that will not stop growing in the predictable future.Type 1 diabetes, formerly called youth, has a genetic component that predisposes to develop autoimmune disease but also an environmental trigger whose identity we still do not know.The incidence of type 1 diabetes - and of many other autoimmune diseases - is also growing accelerated.In recent years the viral hypothesis has gained strength.

Domínguez-Bendala directs a team of ten cell and molecular biologists, although in times of greater financing they became 20. Against the novel image of the abstracted scientist in his microscope, hidden between specimens, his day to day includes key management tasksFor the viability of your investigations:

“I use more than half of my time writing financing requests for my projects, trying to convince NIH reviewers and private foundations that mine are more meritorious than those of my other two hundred competitors.Fortunately, we have a national foundation dedicated to raising money exclusively for the research that takes place in my center.But the competition for external money is ruthless.There are less and fewer resources for a growing amount of researchers around the country.In past times, a project that remained in the twentieth percentile (that is, better than 80% of the competition) received the money invariably.Today one has to exceed at least 90-95% of the competition to have access to the cake.Those who judge these projects, on the other hand, are scientists like those who request them, and sometimes the different schools and differences of opinion weigh more than the scientific merit of the projects.It is an imperfect system.The crisis has also been noticed in the United States, especially in philanthropy.When the economy is buoyant,No other world country compares to it.The figure of the benefactor willing to donate 10 or 20 million dollars to a university or to a research center is not uncommon. ”

a great finding and new lines of research

The working group of this Sevillian scientist has discovered very recently that a naturally synthesized molecule by the body (used for years to regenerate bone tissue, repair fractures and fuse vertebrae) acts on stem cells residing in the pancreas giving rise to formation to the formationof new islets.“We have just published our preliminary discoveries and we are investigating whether the administration of this molecule to diabetic animals induces the regeneration of insulin producing cells within the same pancreas, without the need for transplants.We have many other projects, but the results obtained in it are so promising that right now to bring them to clinical practice is our number one priority. ”

Asked about the level of research in Spain, the scientist applauds the important clinical initiatives in communities such as Andalusia, aimed at integrating a powerful infrastructure for the development of clinical trials throughout the region: “The Andalusian initiative in advanced therapies,Directed by Natividad Cuende, it is a great example. ”In his opinion, the collaboration between teams and professionals from different countries is essential for the progress of science: “In my group we maintain exchange programs with numerous Spanish institutions.In more or less prolonged stays, several years ago we regularly receive medical students, doctoral students and medical professionals already established from Spain. ”

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DiabetesForo
01/14/2018 10:19 a.m.

Hopeful but I am already in an incredulous phase since there are already many noticas that arrive in that nature but the cure that is what the patient who heals him is never being healed and wants a more or less satisfactory measure and does not arrive and notcontinue with insulin punctures and most achieved the MGC and little more

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Garci
01/14/2018 4:51 p.m.

I believe that something will take out I do not know if definitive or what is the treatment of the disease but so many people investigating even money to this if they would not do not make it a block that if I wanted to ask you is that if you understand well it says that with theBeta cell transplants of corpses There are patients with diabetes who have stopped needing insulin

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PGarcía
01/14/2018 5:27 p.m.

@"Garci" for what I have understood, these patients stop needing insulin but they do need to medicate with immunosuppressants since their body insists on trying to eliminate beta cells that have transplanted it.

What I do not know is to what extent these immunosuppressants are undesirable and negative in other aspects.That is, if the risks of having to take immunosuppressants for life compensates for the advantage of not having to puncture you insulin again.

Hijo con DM1 desde Mayo 2017, con 13 años.
Tresiba + Novorapid. Freestyle + Blucon.
Última hemo: 6,8(Noviembre 2018)

  
Garci
01/14/2018 5:39 p.m.

Yes, thanks is that I had happened to me, I understand the same thing now now

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DiabetesForo
01/15/2018 8:58 a.m.

New news appeared yesterday on research type 1 diabetes, from Momen to mice
Link

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