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[IP] Diabetes Cure Study

Cell transplant may offer diabetes cure -study

By Gene Emery

BOSTON,  (Reuters) - Canadian researchers said Tuesday they have developed a 
cell transplant technique that eliminates the need for insulin injections in 
the treatment of diabetes. 

The development is so striking that the New England Journal of Medicine 
released the University of Alberta study almost two months early and put it 
on its Web site, http://www.nejm.org. 

Scientists injected pancreas cells near the liver in eight diabetes patients. 
The cells took up residence in the liver and began producing the long-lost 
insulin that controls blood sugar levels. 

If the results are confirmed in a larger study slated to begin this summer 
and doctors can find a better source for the cells, which must now be 
harvested from cadavers, it could mean the end of insulin-dependent diabetes, 
said Dr. James Shapiro, who led the study. 

``This is going to be a tremendous advance,'' Shapiro told Reuters, 
``certainly for people with type 1 diabetes,'' which is the most severe form 
of diabetes and usually appears in childhood. 

``That's what has been unique about what we've been able to accomplish in the 
past 18 months,'' said Dr. Jonathan Lakey, a co-author of the study. ``Eight 
consecutive patients no longer need insulin shots.'' 

The long-term safety and effectiveness of the technique must still be 

In addition, the recipients must take a combination of three drugs designed 
to prevent the body from rejecting the transplanted cells. Those drugs 
increase the risk of cancer and infection. 

But serious diabetics may regard such risks as a small price to pay when the 
impact of the transplant is so dramatic. 

Shapiro said one of the eight patients who regularly fell into a diabetic 
coma, sometimes as often as three times a week, no longer needs insulin 

``I can now do things I never dreamed I would do, like teaching an entire 
morning or afternoon without stopping to eat a snack or testing my blood 
glucose, (or) going for walks when I want,'' said Mary Anna Kralj-Pokerznik, 
a junior high school teacher who is one of the eight volunteers. 

As soon as the pancreas cells are injected into the blood vessel leading to 
the liver, where the cells take up residence, they begin producing the 
long-lost insulin that controls blood sugar levels. 

``It happens almost instantaneously'' once a critical mass of cells has been 
injected, Shapiro told Reuters. 

Lakey said, ``It's just the pinprick of a catheter going into the side of the 
body near the liver. We want to develop it as an outpatient procedure.'' 

Currently, it takes the cells of two pancreases, matched for blood type, to 
produce an apparent cure, said Lakey. Eventually, doctors hope to be able to 
cull enough cells from a single donated pancreas or find a way to grow the 
cells in the laboratory, making the shortage of organ donors irrelevant. 

``That's where the next leap forward in this field is going to be,'' he said. 

The key to the researcher's success, Lakey said, has been a better method for 
extracting the cells from the donated pancreas and the use of three drugs, 
sirolimus, tacrolimus and daclizumab, to prevent rejection. 

Shapiro said that, over time, he hopes that the technique can be modified to 
require few, if any, anti-rejection drugs. 

The study will be published in the July 27 issue of the Journal. 

13:04 06-06-00
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