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Re: [IPk] Re:breakthrough

Hi all, as the attachment was removed, I was advised to include the article in
the body of a message. If you've covered the ground already, sorry to burden
you, although reading the article was hard work and I am still not sure of the
full extent of the implications for this research. It is something big though,
and may pull the rug from under multi-billion dollars worth of islet cell
transplant research over the next couple of years.


An unexpected breakthrough in diabetes research: can healthy islets be
regenerated from spleen cells?

People with type 1 diabetes have been looking forward to a possible cure from
two sources: islet cell transplantation, or a closed-loop pump system.
According to an announcement made in the journal Science on World Diabetes
Day, a third possibility for reversing type one diabetes has now emerged.

The latest research from Massachusetts centres on the immune process which
destroys our beta cells in the first place. Researchers already knew that they
could reverse this damage in mice with diabetes by a combination treatment
with a protein and selected cells from the spleen (the spleen is a small organ
just below the rib cage on the left. It is involved in making and storing
blood cells). How and why this treatment was effective remained a mystery. In
particular, was the effect simply a reversal of the autoimmune damage to islet
cells, or were new islet cells actually being generated by this treatment? The
purpose of the study was to examine the difference in behaviour of live
against irradiated spleen cells.

The team injected cells from the spleen of healthy male mice (donors), into
female mice with severe diabetes (hosts). They injected some live cells, and
some which had been irradiated. They protected the diabetic mice from the
effects of hyperglycaemia by placing a capsule containing islet cells beside
one kidney for the first 40 days in one group and 120 days in another.

     Live cells injected
     Irradiated cells injected

      40 day implanted islet cell support
     6/9 (67%) mice maintained normal blood glucose
     0/8 maintained normal blood glucose

      120 day implanted islet cell support
     11/12 (92%) had normal blood glucose for 6 months or more
     11/13 (85%) had normal blood glucose for 6 months or more

Table 1: glycaemic control achieved among diabetic mice with varying
combinations of splenic cell therapy

The results show that both treatments were able to generate normal functioning
islets, but the live cells did so much faster. In addition there was little or
no immune reaction around the new islets generated by live cells, while there
was some reactions seen around those generated by irradiated cells.

In a separate experiment, pre-diabetic mice were injected with similar splenic
cells. As previously, new pancreatic islets grew, but in addition the
remaining host pancreatic islets were spared from further destruction. All of
an untreated control group went on to develop diabetes.

What does this research tell us?

Want this study shows is that in mice at least, injecting donor spleen cells
caused these diabetic mice to develop new healthy functioning islets in their
pancreas. This seems to be happening due to mutation in the donor cells. There
was little or no immune reaction, and the treatment seems to reverse the
autoimmune damage to islets in prediabetic mice.

While it is early days to read the implications of this research beyond the
diabetic mouse, there are important potential implications for people with
type 1 and type 2 diabetes. The main implication for type 1 is that it may be
possible to regenerate healthy islets from donor spleen cells to a point where
normal glucose control is achieved and the diabetes is essentially cured. A
second implication is that adult cells may after all prove to be as effective
as those derived from embryos, providing huge ethical relief to the medical
profession and to people with diabetes. The protective effect of this
treatment in prediabetic mice also offers some hope to people with type 2
diabetes, or in the early stages of type one. This is a very novel and
exciting development, and we in Diabetes Ireland will be keeping a close eye
on it!

Reference:  Islet Regeneration During the Reversal of Autoimmune Diabetes in
NOD Mice. Shohta Kodama, Willem K|htreiber, Satoshi Fujimura, Elizabeth A.
Dale, Denise L. Faustman Volume 302, Number 5648, Issue of 14 Nov 2003, pp.

Full paper available online from:  http://www.sciencemag.org

  ----- Original Message -----
  From: Tori
  To: email @ redacted
  Sent: Wednesday, November 19, 2003 9:18 AM
  Subject: Re: [IPk] Re:Humalog

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  It's interesting...

  I used (diluted) Actrapid (porcine, "mono-component" and human) in my early
  days of pumping (1978-1995), then Humalog for a number of years both in MDI
  and pumping (1997-2003), and have recently switched to Novorapid in my pump
  with quite dramatic positive results. (The missing two years were MDI using
  Actrapid and not seeing an endocrinologist).

  Personally, I think if you're willing to work at it, you can make virtually
  any insulin system work - at least to the best it will (I have had numerous
  inexplicable disasters in the past).

  Interestingly, I was told by my most recent endocrinologist in October that
  as far as he is concerned, Novorapid is the only insulin recommended and
  approved for CSII. I have found it very good, but have been fortunate to
  really direct where my diabetic management goes rather than having to rely
  on the "experts" (ie. the insulin change was at my instigation, not his).

  Possibly food for thought...


  At 06:46 PM 19/11/2003, you wrote:

  >I have been using Humalog in my pump since 1998 - I was the only pump
  >patient at Edinburgh Royal Infirmary at the time. The Consultant there had
  >been reading up on pumps and if I remember correctly, he had seen a paper
  >somewhere recommending Humalog for pumps. So we discussed pros & cons (all
  >usual problems of changing Insulin) and we decided to switch from Actrapid
  >to Humalog. The change went without a hitch and if anything my hypo
  >awareness increased.
  >Ian Grant
  >It's fast, it's easy and it's free. Get MSN Messenger today!
  >for HELP or to subscribe/unsubscribe/change list versions,
  >contact: HELP@insulin-pumpers.org

  Peer support for Type 1 diabetics, friends, family and others
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