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Pancreatic Cell Transplant Could Lead to Diabetes Cure

Posted on: Tuesday, 19 April 2005, 06:00 CDT

The first successful transplant of insulin-producing cells from a live donor -- a mother to her daughter -- is being reported today by Japanese scientists, raising hopes for a cure for severe diabetes.

Diabetes experts caution that the procedure has been performed only once and in a patient whose diabetes was not typical. But the accomplishment is ''dramatic,'' says Robert Goldstein, chief scientific officer of the Juvenile Diabetes Research Foundation.

Both the patient, a 27-year-old woman, and her mother, 56, are healthy and have normal blood sugar levels, lead author Shinichi Matsumoto and colleagues say. Their article was posted online Monday ahead of publication in the British medical journal The Lancet. The patient is considered cured for now, but whether the disease will return is uncertain.

The procedure was effective using less than half the mother's pancreas. Transplantation of insulin-producing cells, or islet cells, taken from cadavers may require up to three pancreases, though new techniques have been effective using just one.

''This is a significant advance,'' says Alan Cherrington of Vanderbilt University, president of the American Diabetes Association. ''What it says is that if you can get really healthy undamaged islets, it doesn't take as many of them to cure diabetes as it would if they're subject to some trauma.''

If the study's results are duplicated, donations taken from living people could help ease the shortage of such cells, the researchers write. Whether the cells remain viable is unknown, Cherrington says.

Nor is it clear whether the procedure would be as effective in people, like most of those with type 1 diabetes, whose own immune cells have destroyed their insulin-producing pancreatic cells. The Japanese patient's diabetes was caused by chronic pancreatitis, an inflammation, so the risk of an autoimmune attack on the transplanted cells was reduced, the researchers say, and that might have improved her chances.

Diabetes experts also cautioned that the removal of half a pancreas could place the donor at risk of developing diabetes. Only those who have no evidence of prediabetes, obesity or other risk factors could be considered donors, Goldstein says. ''It's not like taking out an appendix,'' he says.

Attempts in the late 1970s to transplant pancreatic cells from living donors failed, partly because the anti-rejection drugs available were ''primitive,'' says James Shapiro of the University of Alberta, a co-author of the article. He pioneered the first successful islet cell transplantation using cells from cadavers five years ago.

''It remains to be seen whether transplant from living donors has same effect,'' Shapiro says. But ''this is the first successful case, and I'm particularly encouraged by the outcome.''

Source: USA TODAY

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