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Family Health Magazine
DIABETES

Islet Cell Transplantation
Exciting research and hope for a cure

Islets in the pancreas produce the hormone insulin. It is these cells that are at the center of research looking for a cure for diabetes. The Immune Tolerance Network (ITN) is a research program funded by the Juvenile Diabetes Foundation (JDF) and the National Institutes of Health (NIH) in the United States. In July 2000, the ITN announced that 10 centres led by the Edmonton islet transplantation group would transplant 40 patients using the 'Edmonton Protocol.'

Only those with 'brittle' Type 1 diabetes, 18 to 65 years of age, are eligible to participate. They must be unable to control their blood sugar even with the most rigid insulin schedule. Children are not involved in the study. The $7.5-million effort will be overseen by the ITN.

This announcement followed a June 6, 2000, article in the New England Journal of Medicine. It described the work of the team from Edmonton at the University of Alberta. They have had amazing success reversing the insulin dependence of seven people with diabetes.

The transplant does not involve surgery. Islets are isolated from an organ donor’s pancreas using a protocol developed in Edmonton and following isolation are placed into the portal vein of the recipient’s liver. (The portal vein is one of the two major blood vessels that take blood to the liver). Blood carries the islet cells to the liver. Even though they are in a different organ, these cells engraft and produce enough insulin. There is almost perfect control of blood sugar.

Dr. James Shapiro spoke on behalf of the Edmonton islet transplantation group at JDF’s annual conference in May. He cautioned that the safety and effectiveness of this therapy can only be known after long-term studies. Until then, it should be used only in patients whose diabetes truly cannot be managed with insulin treatment. It is not for children.

The years of experimental research at the University of Alberta have been funded through a variety of local, national, and international sources such as the Alberta Foundation for Diabetes Research, Edmonton Civic Employees Charitable Assistance Fund, C.F. (“Curly”) MacLachlan and Gladys B. MacLachlan Fund through the University of Alberta Hospital Foundation, Muttart Diabetes Research and Training Centre, Alberta Heritage Foundation for Medical Research, Capital Health Authority, Canadian Diabetes Association, Canadian Institutes of Health Research (formerly Medical Research Council of Canada), Juvenile Diabetes Foundation International, and the National Institutes of Health. As well, human islets are provided through JDF-funded projects to scientists around the world for basic research studies.

Ron Forbes, President and CEO of JDF Canada, stresses the importance of keeping the momentum in this area of research. He went on to say that advances in islet transplantations have been possible as the result of extensive global research efforts. These have been funded by very significant sums of money. As the study extends to a larger number of patients, the need for funding also increases.

Islet cell transplantation is one of the most promising areas of research that provides a better treatment for diabetes. It is high on JDF’s research agenda. However, large and continued funding is needed to keep the pace of discovery moving forward. JDF believes now, as always, that its focus must be in the lab.

More than ever, research is needed to find a cure. JDF believes that a cure will not come from individual scientists, however dedicated to their work. A cure will come from networks of scientists working together around the world.

This is the most exciting time in Type 1 diabetes research since insulin was discovered almost 80 years ago. JDF is excited to be on the leading edge, and will pursue its mission to find a cure for diabetes and its complications, through the support of research. This disease costs the Canadian health care system over $9 billion each year. Imagine the change that will occur when those billions are put to other uses. Every dollar received by JDF is helping to make that change.