In Type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas (islets of Langerhans), preventing the body from producing insulin, which forces patients to rely on regular injections.
Although transplanting insulin-producing cells into a patient can provide a solution, challenges such as donor shortages and the need for immunosuppressive drugs to prevent transplant rejection persist. Stem cell technologies present an alternative by generating an unlimited supply of pancreatic cells derived from the patient’s own tissues, potentially reducing the need for long-term immunosuppression.
A research team from Nankai University, building on previous work by researchers at Peking University, generated cells from three individuals with Type 1 diabetes and reprogrammed them into a pluripotent state, where they can develop into various cell types.
The study utilized small organic molecules to induce the expression of necessary genes. These molecules are easy to produce and could potentially serve as a basis for future treatments of other diseases. In this study, the pluripotent cells were developed into pancreatic cell clusters capable of producing insulin.
Following successful trials in animal models, the researchers proceeded with a human trial in June 2023, implanting around 1.5 million insulin-producing cells into the patient's abdominal muscles. This site was selected over the liver, a more common implantation site, to allow non-invasive MRI monitoring and the option to remove the clusters if necessary.
Have the rules of the game changed?
About two and a half months after the implantation, the patient began producing a sufficient amount of insulin, allowing her to completely discontinue external treatment. For over a year, her blood sugar levels remained within the desired range more than 98% of the time, and she did not require any external insulin injections. Experts, including surgeon James Shapiro from the University of Alberta, have hailed this achievement as a significant success.
Since the patient was already undergoing immunosuppressive treatment due to a prior liver transplant—necessitating anti-rejection therapy—the study was unable to assess whether the stem cells reduced the risk of rejection.
However, the researchers remain optimistic, believing that cells derived from the patient may help address immune response issues. Additionally, the team is exploring the development of pancreatic cells that are resistant to immune system attacks—a key challenge in Type 1 diabetes.
This research is part of broader efforts to use stem cells in diabetes treatment. In another recent case, researchers from Shanghai reported implanting reprogrammed cells into the liver of a 59-year-old man with Type 2 diabetes, allowing him to stop using external insulin.
These advancements mark a breakthrough in diabetes therapy, offering more effective treatment options. If further trials in this field prove successful, they could pave the way for innovative therapies that transform diabetes management and enhance the quality of life for millions.
