Pioneering "Mini-Pancreas" Nullifies Woman's Type 1 Diabetes

A pancreatic islet - seen here next to a blood vessel in a mouse - is a cell type responsible for producing insulin. Jakob Suckale/Wikimedia Commons; CC BY-SA 3.0

We’re a bit of a way from being able to completely grow human organs in the lab for transplantation, but some key milestones have been made. Just recently, working synthetic ovaries were 3D printed and proved to be 100 percent effective, at least in mice. Various heart structures have also been cultivated from stem cells and grown both outside and inside a range of animals.

Now, as reported in the New England Journal of Medicine, a woman with type 1 diabetes has effectively been given a bioengineered pancreas, and it appears to have suppressed the condition. It’s not a cure, but this type of work paves the way for the future eradication of the life-threatening condition.

Type 1 diabetes occurs when the pancreas malfunctions and doesn’t produce insulin, so blood sugar levels cannot be broken down. It’s an autoimmune condition – one that may be genetically inherited – which means that, in this case, the pancreas itself is mistakenly attacked by the immune system.

Insulin injections are currently the only way to control this condition, which can lead to stroke and kidney failure if these boosters, and a very strict diet and lifestyle, aren’t kept up over time. It appears, however, that change is coming.

One promising method is to transplant insulin-producing collections of cells into a patient’s liver. The beta cells within these “islets” quash their high blood sugar (hyperglycemia), but the patients require a particularly heavy course of immunosuppressant drugs afterwards to make sure their immune systems don’t destroy the “alien” cells. Additionally, the liver often bleeds heavily during the operation.

Scientists from the Diabetes Research Institute at the University of Miami decided to take a different path to see how effective it could be. They focused on the omentum (“apron”), a layer of fatty cells that surround several abdominal organs like the stomach and liver.

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The cultured islets, seen here after being injected into the omentum of the patient. DRI/University of Miami Miller School of Medicine

This unusual tissue acts as a support frame for them, and unlike the liver, it is far easier to access, operate on, and transplant cells into. It’s connected to the circulatory system, much in the same way the pancreas is.

The team cultured and transplanted insulin cells into one woman’s omentum, who had spent over half of her life suffering from type 1 diabetes. Such a vast quantity of islets were added to this patient’s omentum that they effectively acted as a mini-pancreas – and, not long after, the woman achieved “insulin independence”.

Her blood sugar levels were back under control and her type 1 diabetes had been silenced, if not cured. Around 17 days post-operation, the patient no longer required any insulin injections. Six months on, and although her insulin levels had dropped slightly, the symptoms of type 1 diabetes had not returned.

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