Diabetes treatment scientists have made significant progress by reprogramming skin cells. The new method involved taking specific skin cells, known as fibroblasts, and turning them into insulin producing pancreatic cells.
When these cells were reintroduced back into mice, that had been genetically modified to have diabetes, the mice showed healthy blood sugar levels.
The ultimate aim of this work is to provide a stem cell based cure for type 1 diabetes. A disease that is caused by the sufferers own immune system, which wrongly attacks insulin producing cells. Type 1 diabetes is a condition that usually appears in childhood, and results in a lifetime of insulin injections, which carries some inherent risk for further health issues. Without insulin, blood sugar levels can rise to lethal levels in sufferers.
Previous attempts to use stem cells for this type of cure have not worked well. The Gladstone Institutes, and University of California at San Francisco, who worked together on this new approach, changed the cells in a more step by step method than before. The difficulty in previous attempts has been put down to the fact that relatively “mature” cells were used for the experiments. This time around the cells were pushed back to much earlier stage of cell development. This meant that they had a much greater chance of regeneration when injected into the mice.
These early cells are known as endoderm cells, and are the basis for all the organs in the body. After the fibroblast had been changed, a second round of preparation was carried out on the cells in the experiment, and they were made into specific early pancreatic cells. These early pancreatic cells successfully produced insulin, responded appropriately to chemical signals, and when injected into the diabetes suffering mice, controlled blood sugar levels.
What was an even stronger indication of success was that within two months these cells had developed into fully functioning pancreatic beta cells. If it was possible to repeat this in humans, it is believed to be a potential cure for type 1 diabetes. The researchers warmly welcomed this as significant progress in the treatment of diabetes.
However, many other stem cell based treatments are facing difficulties with federal laws. The U.S. National Institutes of Health is the source for many US scientists when they want to develop stem cell therapies based on regenerative medicine. The problem is that rules set by NIH do not match those set by the US Food and Drug Administration, and so approval for the therapies, which can only be done by the FDA, may be challenging. The NIH rules are designed for ethical use of in vitro fertilization embryos, whereas the FDA demands significant testing of stem cells to make sure they do not carry some other potentially harmful conditions. The potential cost for the testing of all cells, before a clinical trial takes place, could be huge and is daunting for treatment developers.
With millions of dollars invested in sets of lab based cells, which may now be unusable, this issue is becoming more acute. Many regenerative medicine labs are now looking to the FDA to approve downstream testing rather than source testing.
Without this the significant progress in diabetes treatment and others may be significantly slowed from reaching patients.
By Andrew Willig