A potential cure for Type 1 diabetes

A caveat: 

Please check the facts in this post. I am not a scientist by any means and may have made mistakes in my note-taking at the talk I heard, given by Priye Iworima, and hosted by the Canadian Federation of University Women (CFUW) of which I'm a member.

 

  

 

The Toronto University doctors who discovered insulin were Drs. Banting, MacLeod, Best and Collip. Realising the importance of this, they sold the patent for just $1; Banting said: “Insulin belongs to the world, not to me.” There's a museum in London, Ontario, Banting House, that commemorates the discovery. We intend to visit it during our grandson Alexander's next visit to Canada since he was diagnosed as having Type 1 diabetes at the age of 10.

Priye's family

On Saturday morning I attended a talk by Priye Iworima, from Nigeria. She moved to Canada as an ambitious teenager, adept at track and field sports, trumpet playing, singing and art (she likes to copy portraits) to whom the small town of Grand Prairie in Alberta, came as rather a shock. She attained a BSc in Science from Simon Fraser University in British Columbia, specialising in neurobiology, and these days, supported by a grant from the CFUW, she is working at the University of British Columbia on a PhD thesis on "Optimizing scale-up parameters that would facilitate the product of a large number of cells that could be used in a clinical setting." The cells in question are "islets," clusters of insulin-producing beta cells, that could potentially bring about a dramatic improvement in the lives of people like my grandson. According to the WHO, there are more than 400-million diabetics in today's world. Bio-engineering with islets has the potential to reverse the disease. 

Have you heard of the Edmonton Protocol procedure? In the year 2000...

a small team of University of Alberta researchers had done what until then had been impossible, helping patients with Type 1 diabetes become insulin-independent at an unprecedented success rate of 100 per cent.

The story is exciting but the lasting effects of the treatment are still problematic. Furthermore, there are insufficient donor islets available; after isolation their quality deteriorates, and recipients need to keep taking immunosuppression drugs to prevent their bodies from rejecting the transplanted cells.

The research replicates "cadaveric islets" extracted from a donor's pancreas; Priye is studying the growth of new cells that mimic these healthy beta cells which are "cooked" in the lab in something that looks like a food processor, a bioreactor that keeps them at body temperature. It requires two donor pancreases to create one dose! A "teaspoon" of cells, protected within a sort of teabag with a very thin membrane that keeps out immune cells, can be infused into a recipient's bloodstream, where the hope is that they generate other cells to start producing the insulin that a diabetic's pancreas fails to produce. By experimenting on animals (Priye didn't tell us which animals, and we ran out of time before she could answer my question about this) it has been discovered that their blood sugar stabilizes at normal levels within 140 days of receiving the new cells. 

"Stage 4" cells take four months to develop, apparently maturing faster in females than in males (she didn't indicate why). The scientists are also looking at Stage 6, Stage 7 and Stage 8 cells. Transplanting the more mature cells seems to reverse diabetes more quickly, apparently. Priye analyses the cells being produced in the lab, by means of a chemical called dithizone, that turns them a brick red colour when insulin is detected (see one of the pictures below). The cells develop into clusters and it seems that the size of the clusters can be controlled by being kept "in the same pot."

It's a complex process; is it efficient and scalable? Can an unlimited source of beta cells for transplant be identified? These questions have not yet been answered, although clinical trials have been carried out since 2014. The transplantation of stem cells has proven to be the most effective therapy for diabetes, better than the "crude" injection of insulin that most diabetics are used to. However, a widespread adoption of the new therapy has limited potential for now. Most patients on whom this has been tried have needed two or more transplants and a serviceable device for the implantation of these cells has not yet been created. The future costs are unknown. It might cost a patient $50,000 or $500,000 to undergo the treatment; when asked, Priye wasn't willing to commit herself to a more exact figure.

Priye says that she is cautiously optimistic about the outcome of her work and concluded by saying, "If I can influence one person's life, that would be an amazing privilege!"

Her Twitter account lists several hashtags after her name: #blacklivesmatter, #Stemcells, #diabetes, #BiomedicalEngineer,  #NSERC AlexanderGrahamBellScholar, #womeninSTEM,  #blackandSTEM

I include some screenshots of her presentation slides below: