From Silver Spring, Maryland, USA:
My 11 year old girl was diagnosed with type 1 diabetes about two weeks ago. I have several questions:
- A research team at the University of Alberta (Canada)recently managed a number of successes using islet cell transplants. They are not currently including children in their study, primarily, as I understand it, because of the need to supply immune system suppressants (since the islet cells come from organ donors). Since my daughter has not yet entered the honeymoon phase, she likely has some functioning islet cells remaining. Would it be possible to extract some of her own remaining "good" islet cells, and, either transplant them (in her liver's portal vein), or clone them for later transplant? This would make it unnecessary to use immune system suppressants since the DNA would be her own.
- A research team at the University of Florida (Gainesville) has recently used stem cells to reverse diabetes in mice. They are now working to do the same with human cells. If human stem cells can be differentiated into islet cells, could these then be transplanted into the liver's portal vein? Are there any clinical trials in the works with regard to this research?
- Now, for a relatively simple question. Cake Mate comes in two forms: icing and a gel. The icing specifies its nutritional breakdown. The gel does not. However, since the gel is in a much smaller and manageable tube, I am very interested in the number of carbohydrates it contains.
The ideas that you suggest have some important problems. In the first place, the Edmonton subjects each required the islet tissue from two whole pancreases for success. Since only about 5% of the normal islet cell complement is still present by the time that insulin dependence starts in type 1A (autoimmune) diabetes, it is not hard to see that the islets from a partial resection of an affected pancreas would not be sufficient. One day, culture might be possible, but so far, it has not been convincingly achieved. In any case, if both these obstacles could be overcome, there would still be the need for some immunosuppressive therapy to contain the autoimmune process.
In the meantime, in New Zealand, there is a group trying to get permission to use encapsulated porcine cells. This would certainly solve the problem of availability of tissue and would be a simple outpatient procedure, but there have been anxieties over introducing pig viruses into man.
Stem cells have been used for some years now, in pancreas and kidney transplants, but with the aim of minimising rejection rather than developing specific organ tissue. The potential for the use of stem cells has certainly caught the public imagination though. Nevertheless, techniques for isolating and culturing these cells and, more especially, for defining the environments required for specific organogenesis are still in their infancy. Clinical trials are some years in the future except for bone marrow and Parkinsonism.
As to the nutritional content of the Cake Mate icing gel, one of our dietitians tells me that it has the same composition as the icing, but without the fat. Apparently this format is better suited to decoration.
Original posting 10 Oct 2000
Posted to Transplants
Last Updated: Tuesday April 06, 2010 15:09:14
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