Beta cell “pod” could oust need for insulin injections

By Grace King, Layout Editor

An encapsulated hormone that helps the body process sugar was placed in a Type 1 diabetic in a clinical trial to evaluate the safety of the potential replacement source of daily insulin injections.

Dave, a Type 1 diabetic, received encapsulated stem cell-derived replacement therapy (VC-01) on Wed., Oct. 29, according to the Juvenile Diabetes Research Foundation (JDRF). Type 1 diabetes is a non-preventable autoimmune disease that causes the body’s T cells to destroy insulin producing beta cells, a hormone that helps the body process sugar.

A “packet” of new beta cells, derived from stem cells, was implanted into the clinical trial participant to be monitored. The study is taking place at UC San Diego Health System, with the support of the Sanford Stem Cell Clinical Center, under the direction of Principal Investigator Robert Henry, MD, according to a ViaCyte, a regenerative medicine company.

Dave had a small tea bag-like packet implanted under his skin that will remain in his body for up to 24 months. At that time, the packet will be surgically removed to a new location before his body rejects it because it’s a foreign object, according to JDRF.

“It was gratifying to know that we could do something that we always thought was possible,” Doug Melton, Harvard stem cell researcher said to Harvard Gazette. “Many people felt it wouldn’t work. If we had shown this was not possible, then I would have had to give up on this whole approach. Now I’m really energized.”

“We are hopeful that beta cell encapsulation therapy could one day virtually eliminate the daily management burden for those living with Type 1 diabetes.”

VC-01 prevents complications of diabetes by creating insulin in the body that stops the swing of low and high blood sugar. The encapsulated beta cells also have the ability to reproduce once they are in the patients’ body, which is a really important piece, according to AnnElise Walsh, mother of a Type 1 diabetic.

The encapsulation of the beta cells acts as a protective barrier, keeping out the attacking T cells. The new beta cells release insulin when needed while the barrier protects them from being destroyed by the autoimmune attack, according to JDRF.

Walsh referred to it as a shark cage. “You can be in there, but the sharks can’t get to you. The [encapsulated] pod allows beta cells to produce insulin and it allows the insulin to get out, but it protects from the T cells that kill the [beta] cells.”
The cells in the encapsulated pod act like they would in a healthy person’s pancreas. They react to glucose and create insulin needed to combat that glucose. The beta cells also reproduce, and those reproduced cells continue to react to glucose.

“We are hopeful that beta cell encapsulation therapy could one day virtually eliminate the daily management burden for those living with Type 1 diabetes,” JDRF president and CEO, Derek Rapp, said on JDRF.org.

The immune response that kills off beta cells in people living with Type 1 diabetes is happening non-stop and is part of the immune system. It didn’t happen once and cause diabetes, it is happening constantly, Walsh said. The best way to solve this problem is to figure out how to stop that autoimmune response, but no one’s been able to do that yet, she said.

“Since we can’t stop the immune system from killing those beta cells, we can protect those cells in this encapsulated pod. We’re making progress,” Walsh said.

The question is, is VC-01 a cure?

JDRF employee Sarah Johnson said to the BBC, “This isn’t a cure, it is a great move along the path. It is a tremendous step forward. Replacing the cells that produce insulin as well as turning of the immune response that causes Type 1 diabetes is the long-term goal.”

“If I could take my daughter in every two years and have something implanted to ‘fix’ her diabetes, I would say that it is [a cure],” Walsh said. “Many people would say, yeah, that’s a cure. You get diagnosed and get put in the hospital and you have an in-patient procedure and walk out of there with this pod, have we cured you? Arguably yes.”

However, Walsh also said it is not a biological cure. “A biological cure needs to happen on a lot of levels. My personal definition of a cure is figuring out how to make the immune system stop attacking beta cells. But I think there are different versions of that and on the biological front eventually we will be able to cure this.”

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