A new method is based on the transplantation of pancreatic islets that produce insulin and combines the immune systems of the donor and recipient, thus preventing rejection.
Scientists have managed to cure type 1 diabetes in mice without the need for lifelong immunosuppressant medications.
Type 1 diabetes occurs when the immune system mistakenly attacks the pancreatic islet cells responsible for producing insulin. Without insulin, blood sugar rises to dangerous levels, requiring sufferers to rely on daily insulin therapy. Although islet transplantation has long been explored as a possible cure, it generally requires lifelong use of potent immunosuppressants, which limits its wide use.
published in The Journal of Clinical Investigation, presents a new approach that combines the immune systems of the donor and recipientallowing the body to accept the transplanted insulin-producing cells.
Rather than suppressing the immune system indefinitely, researchers created a “hybrid” immune systemwith a mixture of donor and recipient cells. This combined system teaches the body to recognize the transplanted islet cells as its own, preventing rejection.
To achieve this goal, the team used a combination of antibodies, low-dose radiation and the drug baricitinib, used to treat rheumatoid arthritis. This conditioning process allowed the donor’s bone marrow stem cells to establish themselves close to the recipient’s existing cells without completely destroying the original immune system. The result was a re-educated immune response that no longer attacks insulin-producing cells.
After receiving both stem cells and pancreatic islets from the donor, the mice maintained stable blood sugar levels and continued to produce insulin for at least 20 weeks. Their immune systems remained functional and did not reject the transplanted tissue, says the
The main obstacles to replicate the experiment in humans include finding compatible treatments to replicate the antibody regimen and ensuring sufficient numbers of donor pancreatic islet cells, which are already in short supply. Furthermore, maintaining a stable balance between donor and recipient immune cells throughout a human’s entire lifespan represents a significant challenge, as we have much longer lifespans than mice.
