In a remarkable feat, scientists have managed to convert pancreatic tissue into insulin-producing cells, all without the need for genetic modification. And that’s not even the best part: The researchers achieved this outcome, a first for science, using a drug that’s already FDA-approved for use. This raises the possibility that one day, patients with type 1 diabetes might be able to ditch the daily jabs and start producing their own insulin again. The study has been published in Diabetes.
In patients with type 1 diabetes, the immune system mistakenly sees insulin-producing cells of the pancreas, called beta-cells, as a foreign threat and destroys them. Patients must therefore regularly take insulin injections in order to control blood sugar, but even with proper management there is a risk of glucose levels entering the dangerous extremes.
While much research has focused on improving insulin-delivery or monitoring systems, others are exploring the possibility of replacing this lost pancreatic tissue as a form of treatment. Transplants of insulin-producing cells have actually shown success, but with a shortage of donor tissue worldwide this isn’t a viable option for the masses. Another option scientists are looking into involves giving cells of the pancreas an identity swap.
Most of the cells in this organ are actually not specialized for insulin production, and scientists have shown it’s possible to change their gene expression patterns so that they assume the identity of beta-cells. The problem with this approach is that studies involved genetic manipulation of cells, sometimes using viruses, which carries with it risks to the patient.
Daily insulin injections are an ongoing burden for sufferers of diabetes. Syda Productions/Shutterstock
But there could be an alternative. Researchers behind the present study previously discovered that the pancreas harbors a pool of so-called progenitor cells that can go on to form beta-cells if given the right instructions to do so. Importantly, they found that activating this supply of cells requires, in part, a signaling pathway called the bone morphogenic protein (BMP) pathway. As the name suggests, BMPs, which are molecules scientists term “growth factors,” are involved in the formation of bone, but since this initial discovery scientists have found their roles extend much further than this, coordinating tissue growth and organization throughout the body.
Armed with this knowledge, researchers from the University of Miami began exposing non-insulin producing pancreatic tissue to a single BMP, BMP-7, which is already used to help encourage bone growth. Remarkably, this was enough to prompt them to become clusters of insulin-producing cells that churned out the hormone at levels between 50 and 250 times higher than previously published attempts by other groups. Importantly, these cells were functional when transplanted into mice, not only producing insulin but also responding to fluctuations in glucose levels, just as native beta-cells do.
These findings raise the tantalizing possibility that one day, such cells could be transplanted into diabetic patients so that they can begin producing insulin again. Of course, they would have to be somehow shielded from destruction by the immune system, so perhaps they would need to be coupled with immunosuppressive drugs. But the team hopes these cells could ultimately form part of a bioengineered mini organ that can function as a normal pancreas in diabetic patients. Alternatively, it might even be possible to administer this drug directly into patients and stimulate the conversion of progenitors into beta-cells, but more work is needed to find out if that’s achievable.