Diabecell and other possiblities

[TeresaB]

I understand that my first priority is to manage my daughter's diabetes type 1. However, I can not overlook the fact that there has been so many breakthroughs in medicine and diabetes in the last 10 years. Has anyone ever heard of this product? Xenotransplantation;encapsulation with out the use of immunosuppressive drugs. It seems like a waiting game with who will come out with the best treatment/cure..???:rolleyes::rolleyes:

[Ellen]

I'm enthusiastic about LCT's trials in Russia. There is certainly no lack of porcine islets. I'm pleased they are trying to accomplish this without toxic immunosuppression.

Dr. Elliott responds to questions at The Islet Foundation message board. His most recent response is here:

http://www.islet.org/forum/messages/48395.htm

[TeresaB]

Ellen,
It's good to here a response from someone.
Glad to hear you are enthusiastic about this! I appreciate the response from Dr. Elliot too. I'm keeping my fingers crossed and willl continue to look into different avenue for a cure.
Talk to you soon,

Teresa

[StillTypeI]

Ellen and Teresa, the idea of a “encapsulated” islet has to be one of the poorest ideas for the control of Type I diabetes that I have seen over my 16 years with the disease. Here is why:
1. Fibrosis. Any foreign body placed in the peritoneal cavity as is suggested for these encapsulated islets, will be met with fibrosis covering the device/devices. This will lead to,
2. Cell death. The life expectancy of a islet cell outside it’s native environment is limited. The pancreas is a highly vascularized organ, as such islets do not respond well or survive well when placed in other environments, especially the closed, or semi closed environment of a “capsule”.
3. Retrieveabilty. Let’s say you have implanted a few thousand of these encapsulated islets in the peritoneal cavity, they are met with eventual cell death and fibrosis surrounding the capsule. How do you intent to retrieve them? Fishing in the peritoneal cavity is not something I or anyone else would recommend.
4. Lead and lag times. Okay so I have implanted a few thousand encapsulated islet cells into my peritoneal cavity. If you recall from number 2 above, islets in their native environment are highly vascularized. Enclosing these islets will lead to lag and lead times of the islets ability to sense and respond to glucose. So the curve of glucose that the host is experiencing and the response to it will not be in alignment. Not good. Especially for children who may or may not rely on others when experiencing hypoglycemic episodes.
5. History. The “encapsulated” islet(both micro, macro and even sheet) has been attempted ad nauseum over the last 15 years. The list of companies that have come and gone attempting this are many, the dollars spent attempting this I am sure run into the hundreds of millions. Off the top of my head I can remember: Encelle, Vivorx, MicroIslet, AmCyte, Islet Technology, Cero Medical. And that is just off the top of my glucose challenged brain!

This idea will NEVER work. Period.

[TeresaB]

Well, I do understand your points. However, I'm not quite sure if I believe "NEVER". I do not find any information confirming that fibroids will develop and the immune system will "re-attack" based on this evidence along with retrieving the cells (when the problem arises), and lag effect problems. Do you have the sceintific data/evidence to back it up? If so, please provide it. I'd like to review it. Can you suggest that maybe I follow up with some of these companies to get a more definitive answer? I did look up some of these companies names that you provided, and do not see the follow up from their clinic trials. Is it because they failed or are they coming closer to a "better" treatment perfecting their mistakes? Also, is it transplantation or xenotransplantation that you're talking about? Did these companies provide transplantation with immunosuppressive drugs that did not work?

Yes, I do believe that there may be certain long term side effects that will result from this experimentation, but isn't that why we continue to do scientific studies? I'm not saying that this will be a "sure thing", but especially after speaking to my doctor today, who is from a reputable hospital with in a populated area, that there is hope...

[Ellen]

I remain optimistic re LCT.

Although this is a mouse study and I do not jump for joy over any rodent study, I am pleased that research is being pursued for encapsulation. This is from the ADA 67th scientific sessions

Transplantation of Encapsulated Embryonic Progenitor-derived Insulin-producing Cells Reverses Hyperglycemia in Immune-competent Diabetic Animals

Year: 2007
Abstract Number: 2057-P


Authors:
SHIYING SHAO, FEI XIE, RUIHUA LUO, MANUEL SALTO-TELLEZ, SAI KIANG LIM, GUODONG LI, Singapore, Singapore



Results:
Severe shortage of cadaveric pancreata has limited the effective therapy of type 1 diabetes by transplantation of isolated human pancreatic islets. Consequently, alternative approaches are intensively explored to generate surrogate beta-cells. We were able to differentiate mouse early embryo-derived progenitor cells into insulin-producing cells (referred to as MEPI-1 cells) which synthesize high levels of insulin, secrete insulin and C-peptide in response to elevated glucose, and can be propagated extensively in vitro. Transplantation of MEPI-1 cells under kidney capsules or subcutaneously in the axilla in streptozotocin (STZ)-induced type 1 diabetic immune-deficient SCID mice corrected hyperglycemia. However, transplantation of these cells in STZ-induced immune-competent diabetic mice only transiently corrected hyperglycemia for a few days. Severe inflammation at the transplantation site suggested acute immune rejection of MEPI-1 cells and consequently the failure to sustain reversal of hyperglycemia in immune competent mice. To circumvent this problem, MEPI-1 cells were micro-encapsulated in barium alginate (capsule size of 400-600 [micro]m) using an electrostatic encapsulator. After overnight culture, the encapsulated cells (2.5-10 x 106) were transplanted intraperitoneally into immune-competent diabetic mice. Normoglycemic level was restored within 1-3 days, followed by development of hypoglycemia varying from 51-80 mg glucose/dL. Despite the hypoglycemia, these mice maintained a level of physical activity and weight gain comparable to that of non-diabetic controls. After more than 3 months, there was no relapse of hyperglycemia in these immune-competent diabetic mice implanted with encapsulated MEPI-1 cells. These results suggest that embryonic progenitor-derived insulin-producing cells may be used as the surrogate beta-cells to develop the transplantation therapy for type 1 diabetes.



Category:
Transplantation

[Ellen]

http://www.diabetesresearch.org/Newsroom/Publications/ResearchUpdateSpring2007.htm

Emerging Technologies: anoencapsulation

The DRI’s Tissue Engineering group is aggressively pursuing the development of nanoencapsulation technology, the newest area in immunoisolation research. The scientific team is applying the same layering technology that is currently used by the electronics, optics and sensor industries to surround the cells with a protective casing.

By adapting this methodology to cell-based science, researchers are developing biocompatible coatings on the same scale as the cell membrane. These coatings can serve as a type of “camouflage” for the implanted islets, allowing them to go unnoticed by the body and avoid inflammatory reactions or immune attack.

Another major advantage of this type of encapsulation is minimizing the size of the capsule and virtually eliminating the problem of oxygen delivery created by the space inside traditional microcapsules.

The very thin coating has relatively little effect on diffusion in and out of the cell. Researchers are evaluating how effective multiple layers could be in protecting islets. In another step forward, new technology is providing the tools to enable nanocapsules to actually defend themselves. DRI researchers are developing more “active” capsules by attaching anti-inflammatory molecules to their surface to reduce adverse reactions, such as the formation of clots and the infiltration of leukocytes into the islets.

To further these efforts, the DRI established a partnership with Dr. Jeffrey Hubbell, professor and director of the Integrative Biosciences Institute, and professor of the Institute for Chemical Sciences and Engineering at Ecole Polytechnique Fèdèrale de Lausanne, Switzerland. Dr. Hubbell is world renowned for his work with biomaterials for tissue engineering and drug delivery.

The collaboration will focus on developing new encapsulation devices and investigating strategies for local drug delivery at the transplant site.

>> View Video Comments from DRI Researcher Cherie Stabler, Ph.D.
(http://www.diabetesresearch.org/Newsroom/Publications/CherieStablerPhD.htm)

[TeresaB]

Ellen,
Thank you so much for the info.!
Good to hear from you!
Teresa