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From Frederick, Maryland, USA:

I have been researching everywhere and there have been many statements made stating a cure in 5 years, but looking through here it does not seem to be so; our ped endos did not mention it. Some research sites seem to indicate that they have transplanted islet cells with a protective coating of some kind and no need for immunosuppressants. It seems to take a long time to get anything going about diabetes and things are being done everywhere separately, never in conjunction. Would not an organized effort by all the minds work better or is it a matter of ego or a matter of finances?


I think you really are mistaken in supposing that there has been any sort of conspiracy to delay progress in islet cell transplantation technology or other research towards finding a cure. There was an International meeting on this theme a few months ago and there is extensive well funded research going on especially here in the U.S.

Without spending time on the important recent advances in conventional therapy and the considerable effectiveness of immunosuppressed whole pancreas transplants, let me try to summarise the present position in regard to islet cell allografts, i.e., human islet cells.

The Diabetes Research Institute in Miami have had considerable success with isolating the islets from a single human pancreas and injecting them into the portal vein to the liver. There is a complex program of immunosuppression; but this can be reduced by two transfusions of donor bone marrow about a week after the islet cell transfer. This is to produce something called chimerism which reduces the chance of rejection. Insulin can usually be stopped by six months and all immunosuppression by one year.

This approach is still experimental, however, and of course it does not deal with the problem that human pancreases are in very short supply or with the need for immunosuppression. However porcine islets in microcapsules have been shown to work in some primates without immunosuppression. The troubles with this approach however have been the difficulty of harvesting islets that have a reasonable life, of doing this in a way that the graft can be removed, which the FDA demand, and of making absolutely sure that these cells do not produce what is called the 'graft versus host reaction'.

Other studies are attempting to culture islet cells and to modify their surface proteins so that they are not recognised as 'non self' by the host's immune system.

Wide availability of islet cell transplants is still some way away; but progress is steady.


Original posting 14 Apr 1998
Posted to Research: Cure


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