Could Stem Cells One Day Cure Diabetes? (medscape.com) 42
Brian Shelton's type 1 diabetes was treated with an infusion of insulin-producing pancreas cells (grown from stem cells). In 2021, the New York Times reported:
Now his body automatically controls its insulin and blood sugar levels. Shelton, now 64, may be the first person cured of the disease with a new treatment that has experts daring to hope that help may be coming for many of the 1.5 million Americans suffering from Type 1 diabetes. "It's a whole new life," Shelton said. Diabetes experts were astonished but urged caution. The study is continuing and will take five years, involving 17 people with Type 1 diabetes.
"By fall 2023, three patients, including Shelton, had achieved insulin independence by day 180 post-transplant," MedScape reported (in January of 2024): In the phase 1/2 study, 14 patients with type 1 diabetes and impaired hypoglycemia awareness or recurrent hypoglycemia received portal vein infusions of VX-880 [Vertex Pharmaceutical's pancreatic islet cell replacement therapy] along with standard immunosuppression. As of the last data cut, all 14 patients demonstrated islet cell engraftment and production of endogenous insulin. After more than 90 days of follow-up, 13 of the patients have achieved A1c levels < 7% without using exogenous insulin.
Brian Shelton and another patient died, and while Vertex says their deaths were unrelated to the treatment, they have "placed the study on a protocol-specified pause, pending review of the totality of the data by the independent data monitoring committee and global regulators." (MedScape adds that Vertex "is continuing with a phase 1/2 clinical trial of a different product, VX-264, which encapsulates the same VX-880 cells in a device designed to eliminate the need for immunosuppression.")
And meanwhile, a new study in China (again using stem cell-derived islet tissue) has provided "encouraging evidence that islet tissue replacement is an effective cure for diabetic patients," the researchers wrote in Nature. The treatment was administered to 59-year-old, type-2 diabetic.
"Marked changes in the patient's glycemic control were observed as early as week 2," the researchers write, and after week 32, the patient's Time In Tight Range (TITR) "had readily reached 99% and was maintained thereafter."
Thanks to long-time Slashdot reader hackingbear for sharing the news.
"By fall 2023, three patients, including Shelton, had achieved insulin independence by day 180 post-transplant," MedScape reported (in January of 2024): In the phase 1/2 study, 14 patients with type 1 diabetes and impaired hypoglycemia awareness or recurrent hypoglycemia received portal vein infusions of VX-880 [Vertex Pharmaceutical's pancreatic islet cell replacement therapy] along with standard immunosuppression. As of the last data cut, all 14 patients demonstrated islet cell engraftment and production of endogenous insulin. After more than 90 days of follow-up, 13 of the patients have achieved A1c levels < 7% without using exogenous insulin.
Brian Shelton and another patient died, and while Vertex says their deaths were unrelated to the treatment, they have "placed the study on a protocol-specified pause, pending review of the totality of the data by the independent data monitoring committee and global regulators." (MedScape adds that Vertex "is continuing with a phase 1/2 clinical trial of a different product, VX-264, which encapsulates the same VX-880 cells in a device designed to eliminate the need for immunosuppression.")
And meanwhile, a new study in China (again using stem cell-derived islet tissue) has provided "encouraging evidence that islet tissue replacement is an effective cure for diabetic patients," the researchers wrote in Nature. The treatment was administered to 59-year-old, type-2 diabetic.
"Marked changes in the patient's glycemic control were observed as early as week 2," the researchers write, and after week 32, the patient's Time In Tight Range (TITR) "had readily reached 99% and was maintained thereafter."
Thanks to long-time Slashdot reader hackingbear for sharing the news.
Not like this, no (Score:3)
The two paths (currently) most viable to cure dabetes:
1. Encapsulated beta cells.
2. Tolerogenic vaccination PLUS beta cell transplant
Just transplanting stem cells and broad immunosuppression is dumb.
Re: (Score:3, Interesting)
Just transplanting stem cells and broad immunosuppression is dumb.
A bone marrow transplant is a kind of stem cell transplant, a kind of transplant that has changed the immune systems of patients before. I recall some notable cases of people being cured of HIV/AIDS from a bone marrow transplant, a fortunate side effect of the transplant for treating some other ailment. There's just some people that are naturally immune to HIV/AIDS and those getting a BMT from them will likely gain this immunity. Type I diabetes is a flaw in the immune system where the body believes insu
Re: (Score:2)
Were we talking about HIV treatment? I didn't say all stem cell transplants in general were dumb in all cases. I said stem cell transplant with lifelong immunosuppression is dumb within the context of treating diabetes.
Re: (Score:3)
No question. This is why Vertex is already working on approach (1) in a more recent trial (VX-264).
The immune attack must be stopped in one of three ways: either by broadly disabling it (e.g. VX-880 trial), selectively suppressing/disabling it (tolerogenic vaccination or "inverse vaccine", which Anokion is working on), or physically blocking it (encapsulated beta cells, e.g. VX-264 trial). Either way, beta cells must be infused or regenerated. The new beta cells can come from another donor's stem cells (Ver
1.5 million Americans suffering from Type 1 (Score:2, Troll)
The 35 million suffering from type 2 are still going to die.
Re: (Score:2, Insightful)
Umm, so why aren't you curing it?
Re: (Score:2)
The same reason why nobody else is curing Type 2 diabetes.
Re: (Score:3)
Type 2 diabetes makes huge money for the drug industry, and to a lesser extent, big sugar. No way a permanent cure hits the market.
Face it, we could eliminate 50% of the cases of Type 2 diabetes by becoming a "nanny" state and regulating the sugar content of processed foods. There is no political appetite for that.
Re: (Score:2)
How would they block a permanent cure? It would take a vast conspiracy of doctors. The Type II diabetes industry is $32 billion. For comparison the automobile market was $150 billion in 2012 and they couldn't stop Tesla. Same thing with Boeing/Lockheed/ESA etc. being unable to stop SpaceX reusable rockets. Microsoft/Nokia were unable to stop the iPhone.
Re: (Score:3, Informative)
How would they block a permanent cure? It would take a vast conspiracy of doctors. The Type II diabetes industry is $32 billion. For comparison the automobile market was $150 billion in 2012 and they couldn't stop Tesla. Same thing with Boeing/Lockheed/ESA etc. being unable to stop SpaceX reusable rockets. Microsoft/Nokia were unable to stop the iPhone.
The permanent cure is "stop eating crap, and do 3h weekly of vigorous physical activity". It's not any weeeevil industry stopping it, it's the lazy slobs who want a pill rather than fix their lifestyle. And if any nanny state tries to take from me the the *occasional* treat (like chips or coke or whatever) because some lazy slob thinks it's a good idea to subsist on a diet made up of purely those, there will be intense pushback.
Re: (Score:2)
How does people avoiding sugar to avoid complications of type 2 benefit Big Sugar?
Who should drive medical research? (Score:1)
One cannot answer such question without a lot of trial and error... Which is a very costly process — so costly, it is impossible to do it just out of benevolence alone. You need a financial motive. Either the reward of a good steady salary (regardless of outcome), or a promise of a spectacular payout in case of success — or some combination of both.
Who would be the payer? Right now around half of this research is funded by the Federal government.— ind
Re: (Score:1)
but a government's ideal citizen would die a months after retiring from workforce
If this guy's idea catches on [yahoo.com], this will happen. He wants everyone to work until they drop so they can't collect the Social Security money they've been putting in. Needless to say, he's one of the elites lives in their own bubble (and in his case a gated community), so they want people to work until they die. Growth at all costs and all that.
Re: (Score:2)
That was the entire idea behind Social Security in 1934.
Re: (Score:2)
Or the anti-aging medicines and procedures? Why would government fund those, if, as a result, there'll be (much) more retirees collecting pensions?
Presumably the government would want anti-aging treatments so people are productive longer. If people expect that they will die at 75 years then they will continue to expect a pension starting at 65 years. If people expect to live to 95 years then they will expect to have to keep working until 75 or 80 before retirement. Having more people with decades of work experience in various fields would be very beneficial to future prosperity. Imagine if those that worked on Apollo had another 10 healthy years o
Re: (Score:2)
You'd think so, and yet... Some are worried about "social costs", others are afraid to even touch the topic of raising the retirement age, yet others — as I cited — deem the very desire to live long "unethical".
We're certainly moving in that direction — the high costs of healthcare and the diffic
Re: (Score:2)
Remember this is Type 1 diabetes, which is not caused by obesity or lifestyle/behavior.
Four words (Score:2)
Re: (Score:2)
Dieting is not easy. The more I try to diet, the hungrier I feel and the grumpier I feel: neckbeard-esque. Some say if you "do it long enough" your body will eventually adjust. However, it's not clear if that "cruise mode" kicks in for everybody or just some, and it's easy to inadvertently undo at say Thanksgiving.
We evolved to do physical labor most the day. People who do physical labor all day are often fairly trim even when not dieting. But it's unrealistic to recreate that. (Europe's dependence on publi
Re: (Score:1)
Stop trying to change your diet radically, and just work out. You can burn more calories/hour in a gym than you will in a factory (or on some farms, granted some farm work is brutal), and you can perform exercises that are far more ergonomic manual labor. Focus on weight lifting + HIIT (maybe) for maximum fat burn, if that's what you're really going for, but that's not absolutely necessary.
Re: (Score:2)
It's easier to just keep on eating whatever you're eating and increase activity than it is to curtail eating. Most dieticians want people to diet AND exercise at the same time.
Eventually you have to do something challenging to fix your metabolic ship, and given the choice between diet + exercise or just exercise, the latter is always going to be simpler and more attainable.
Eventually you may elect to change your own diet (instead of being browbeaten into doing so by a doctor or, worse, peer pressure) to fa
Re: (Score:1)
Shit, my wife is on Slashdot now.
Re: (Score:2)
Re: (Score:1)
Re: (Score:2)
Don't blame the food industry, blame the gluttons buying crap and getting fat. Oh, and also the body positive idiots that think "obese is beautiful" .. if you're married you're screwed .. but even single is screwed because you can't date a woman longer than 6 months or maximum one year because they start getting fat after that.
Re: (Score:2)
Type 1 diabetes is not from overeating. It is an auto-immune disease that will emerge in otherwise healthy children. Perhaps a poor diet can "trigger" this disease earlier in life but it's going to happen eventually as the immune system erodes away the body's ability to produce insulin.
Re: (Score:2)
There does seem to be a link between crappy diet (YES, that doesn't mean genes don't play a role too), and the body's immune system deciding to eradicate the beta cells for teh lulz.
This is only true once the disease has already progressed to Stage 2 (dysglycemia, destruction of most beta cells). A careful low-carb diet from that point on can somewhat delay the progression from Stage 2 to Stage 3 (insulin dependence and destruction of nearly all beta cells), but cannot stop it altogether. No link has ever been shown between diet and development of the disease itself, with the possible exception of A1 beta-casein protein in milk being a potential trigger for those who are genetically predisposed. (Studies are divided on this.)
Re: (Score:2)
By that logic, heart disease isn't a disease either. Neither is lung cancer caused by cigarettes. That's an absurd take. Behavior-induced diseases are still diseases.
Of course, this article is primarily about Type 1 Diabetes, which emphatically fits every definition of a disease, and is uncorrelated with lifestyle or behavior.
Ya, but ... (Score:2)
South Park on stem cells [youtube.com]
Type toodleoo (Score:2)
So Type II is about lack of insulin production? Or insulin resistence? Or something? Can we stop running around like chickens with their heads cut off?
Re: (Score:3)
Type I is an autoimmune disease (not lifestyle-correlated) that reduces insulin production, and cannot be reversed through lifestyle changes. Type II is a metabolic disease (lifestyle-correlated) that creates insulin resistance, and can sometimes be at least partially reversed through lifestyle changes. Come to think of it, for Type II, running around like a chicken with its head cut off (for 20-30 minutes a day) may in fact comprise part of such an effective lifestyle change.
Already did once (Score:2)
Re: (Score:3)
Before W, America was using Stem cells to work on various things. In particular, a group at CU injected on the pancreas where a patients islet had stopped, and it WORKED. It started producing insulin. IIRC, part of the trick was that it had been a functioning islet, as opposed to someone born without it.
Pedantically, everyone is born with functioning islets. Type 1 Diabetes often strikes in childhood, but can strike at any age. That's why the term "juvenile diabetes" has fallen out of favor and is no longer used.
The problem of simply injecting new stem cells (or beta cells) is that they only work for a short while; the immune system will quickly attack and kill them, and you're back where you started. The trick is is to either block this autoimmune response (broadly through immunosuppression, or selectivel