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Univ. Developing Implanted Islet Cell Bags for Diabetes

Klearchos Papas

Klearchos Papas, holding an implantable islet bag (Univ. of Arizona College of Medicine)

8 Mar. 2019. Implantable collections of insulin-producing islet cells resembling tea bags, for people with type 1 diabetes, are being developed by researchers at University of Arizona. The team creating the technology, led by Klearchos Papas, a professor of medical imaging and scientific director of Arizona’s Institute for Cellular Transplantation in Tucson, is funded by a 2-year, $1.2 million grant from JDRF, an advocacy and research funding organization on type 1 diabetes.

People with type 1 diabetes have an inherited autoimmune disorder where islet cells in the pancreas do not produce insulin. Type 1 diabetes is diagnosed primarily in children or young adults, where the immune system is tricked into attacking healthy cells and tissue as if they were foreign invaders, in this case, insulin-producing islet cells. From 5 to 10 percent of people diabetes have the type 1 form, estimated at 1.25 million in the U.S.

Few treatments for type 1 diabetes are available beyond managing the condition day to day. But even with the most advanced technologies are no guarantee of serious complications, such as blindness, amputation, and kidney failure . “Even with automated insulin delivery devices and continuous glucose monitoring, the best way possible to control your blood sugar, says Papas in a university statement, “you still can end up with these consequences.”

The solution pursued by Papas and a team of associates from St. Vincent Institute in Australia and University of Alberta in Edmonton, is to implant a device that senses the need for insulin, then releases insulin from live islet cells. While it’s possible to transfer donated islet cells into people with type 1 diabetes, the donated cells can invoke serious immune system reactions. Thus islet cell transfers are only considered for the healthiest adults who can tolerate drugs needed to suppress immune system responses, and not children or others with compromised immune systems.

Papas and colleagues have been working on a method for safe implantation of donated islet cells for nearly 2 decades, and advanced the technology to where they believe it can be made small enough and functional for people with type 1 diabetes, without the need for drugs to suppress the immune system. The solution packs donated functioning islet cells in a permeable bag, like a sachet or tea bag, that allows the islet cells inside to interact with the blood stream to sense glucose levels and release insulin, yet still separate the islet cells from detection by the immune system to prevent a damaging response.

One problem facing the team up to now was making the device small enough for implantation. The researchers were able to reduce the number of islet cells needed and packed the cells more tightly together to shrink the bags’ size. The team also devised a small oxygen source, which islet cells need to produce insulin. “Islets are happier with an oxygen supply,” notes Papas. “They survive and function better and this has been overlooked in the past.”

The project calls for Papas’s team to test the devices in pigs, which have organs similar in size and function to humans. But the researchers believe the technology could also work with human stem cells that transform into functioning islets, which would provide an unlimited source of insulin and reverse the disease. Diabetes drug maker Novo Nordisk is providing islets derived from stem cells to test with the implanted bags.

If the advances planned in the new project are successful, the researchers believe the technology could be ready for human clinical trials in 3 to 4 years. “This is not pie-in-the-sky crazy science,” says Papas. “We believe, engineering-wise, it is achievable.”

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