Implant promises widened access to life-saving diabetes treatment

Long-term survival of encapsulated islets without immunosuppression via inflammation-induced neovascularization.

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Researchers from the University of Alberta and Cornell University have developed an implantable device that can release insulin without causing an immune response. Published in Nature Biomedical Engineering, the study led by James Shapiro and Minglin Ma suggests this device could improve accessibility and safety in insulin-producing cell transplants for diabetes. 

In tests on mice, the device showed sustained cell survival. It reversed diabetes without the need for anti-rejection drugs, potentially offering a safer alternative to current transplant procedures with lifelong drug use.

Shapiro, the Canada Research Chair in Transplant Surgery and Regenerative Medicine who also leads the Edmonton Protocol, said, “If we could do a transplant with less or no anti-rejection drugs, we could do it much more safely, and we could include more patients who could benefit.”

Most successful islet cell transplants are currently grafted into the liver. However, monitoring or removing the transplanted cells from the internal organ is hard. This new research combines groundbreaking work by Shapiro and Ma to make the transplantation technique more accessible. 

Shapiro’s team created a potential alternative transplant site under the skin by placing a plastic tube in the forearm, allowing blood vessels to form around it, then removing the device and leaving behind a vascularized pocket for transplantation. Ma’s team created a removable polymer thread containing thousands of islet cells protected by a thin hydrogel coating that could be implanted into a patient’s abdomen without triggering an immune response.

Shapiro recalls, “I was intrigued by Ma’s approach as it avoided the need for immunosuppression. I wondered if we might combine our two innovative strategies to improve cell survival. And indeed, it worked! Combining the two, really did improve the skin site for engrafting cells without the need for anti-rejection drugs. The data are very compelling.”

Shapiro advises further testing in larger animals and eventually humans to fully understand the potential of the promising results. The teams have named their approach ‘SHEATH’ (Subcutaneous Host-Enabled Alginate Thread). This method holds promise for testing other hormone-producing cell transplants, offering potential treatments for conditions like anemia and chronic renal disease.

In conclusion, the experimental implant developed by researchers from the University of Alberta and Cornell University holds promise in expanding access to life-saving diabetes treatment. The implant, capable of insulin secretion without triggering an immune response, presents a potential breakthrough in diabetes care. 

While further testing and exploration are needed, this innovative approach marks a significant step toward making crucial treatments more widely available, offering hope for improved outcomes for individuals with diabetes.

Journal reference:

  1. Wang, LH., Marfil-Garza, B.A., Ernst, A.U. et al. Inflammation-induced subcutaneous neovascularization for the long-term survival of encapsulated islets without immunosuppression. Nature Biomedical Engineering. DOI: 10.1038/s41551-023-01145-8.

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