Researchers at the University of Alberta’s Alberta Diabetes Institute (ADI) are in the process of developing a long-term cure for Type 1 diabetes—for the second time.
The research team has been able to cure diabetes in mice using the new process, and are hopeful that they will be able to replicate those results in humans.
The new cure being developed by the researchers, which uses stem cells from the patient instead of donor islet cells, aims to treat patients in the long-term without the use of anti-rejection drugs.
Although this treatment has been successful in reversing Type 1 diabetes in mice, further testing in mice and additional funding for equipment are required before human trials can begin.
A previous cure developed by the same researchers in 2001—a method called the Edmonton Protocol—required long-term use of anti-rejection drugs, which can make patients susceptible to infection and increase their risk of cancer.
The Edmonton Protocol is a long-term Type 1 diabetes treatment method of implanting pancreatic islet cells from a donor to facilitate the production of new insulin cells in patients with Type 1 diabetes.
British Canadian surgeon Dr. James Shapiro is the researcher who has led the development of the Edmonton Protocol for 20 years.
Following rapid human trials and approval from Health Canada and the Alberta provincial government, Dr. Shapiro and his colleagues have been able to begin treating patients residing in Alberta with islet cell transplants. Other islet cell transplant facilities have been established in Montreal and Vancouver.
Due to insufficient quantities of anti-rejection drugs, donor islet cell injections are restricted to patients with exceptionally high blood sugar levels. Dr. Shapiro said a sustainable cure for Type 1 diabetes would require cells not needing anti-rejection drugs.
Dr. Shapiro explained that theoretically, if a patient’s own cells are reprogrammed and re-injected, the risk of rejection is reduced. However, he said this may not be the case in practice.
“I think one of the big theoretical challenges is when you put patients’ own cells back in and you don’t give anti-rejection drugs, the autoimmune process may still be active and may destroy the new cells,” Dr. Shapiro said.
He said that reprogramming cells without using drugs might require an additional protocol for patients with Type 1 diabetes to ensure their own cells are not destroyed by the autoimmune process.
ADI has adopted another protocol, developed by Dr. Timothy Kieffer at the University of British Columbia’s Diabetes Research Group, for creating insulin-producing islet cells.
“Collectively, we believe that a combination of these approaches will lead to the development of [a] cure for certain forms of diabetes in the near future,” said Peter Light, director of the ADI.
In a short time, ADI has put this protocol into theoretical laboratory practice, which would entail sampling blood from diabetes patients, turning the blood cells into induced pluripotent stem cells and transplanting them into patients as islet cells.
“We are very excited about this approach,” Dr. Shapiro said. “We think it really is possible to cure diabetes with these kinds of cells.”
According to Melanie Hibbard, executive director of Diabetes Research Institute Foundation Canada (DRIFCan), 450 million people suffer from diabetes worldwide, of whom 10 per cent suffer from Type 1 diabetes.
Having two sons with Type 1 diabetes, Hibbard said she understands the challenges associated with the disease.
“That is the reason that I got involved [with DRIFCan]. As a parent, I’m not just going to sit by and let this happen. I’ve got to do something, whatever I can do,” Hibbard said.
“We talk about pandemics and what’s happening around the world, and diabetes is a pandemic.”
Grassroots initiative HEADing to 2022, partnered with DRIFCan and launched in May 2020, aims to raise $22 million for diabetes research by 2022.
While COVID-19 restrictions only permit one researcher to be in the labs, Hibbard said Dr. Shapiro and his colleagues have been successful in communicating between themselves and with other researchers around the world.
This year marks the 100th anniversary of the Canadian discovery of insulin, when it was encountered and developed at the University of Toronto in 1921 by Frederick Banting, Charles Best, James Collip, and John Macleod.
“The insulin treatment is life-saving for patients with Type 1 and for some with Type 2 diabetes, but it’s not a cure and, 100 years later, we’re now ready for something better,” Dr. Shapiro said.
He said technology is helping to transform imaginative possibilities into realities, and added he is excited for Canada to surpass expectations in science.
“Canada was a leader from the beginning with the discovery of insulin,” Dr. Shapiro said. “We’re really proud as Canadians to continue that scientific tradition.”
Feature image via screen grab.
