2021 is the 100th anniversary of the discovery of insulin. In 1921, insulin was discovered by Sir Frederick G Banting, Charles H Best and JJR Macleod at the University of Toronto. It was first used in a human to treat diabetes in 11 January 1922. Before 1921, it was exceptional for people with type 1 diabetes to live more than a year or two. It is one of the greatest medical discoveries of the 20th century, and it remains the only effective way to treat type 1 diabetes today.
The discovery of insulin has saved millions of diabetic patients, especially those with type 1 diabetes. For patients with type 1 diabetes, it can only be maintained by insulin therapy, and there is no other way to solve the fundamental problem that causes the disease - pancreatic islet cells cannot produce insulin by themselves. Type 1 diabetes must be treated with insulin, so it is also called insulin-dependent diabetes.
On October 18, 2021, Vertex Pharmaceuticals Incorporated announced that a patient with severe type 1 diabetes has achieved a "stable recovery" of islet cell function after receiving fully differentiated pancreatic islet cell replacement therapy derived from its stem cell called VX-880. These restored pancreatic islet cells can make patients to regulate insulin and even produce insulin by themselves, reducing their daily insulin consumption by 91% and significantly improving blood sugar control. This is the world's first successful case of stem cell therapy for type 1 diabetes.
About the VX-880
VX-880 is a stem cell-derived pancreatic islet cell replacement therapy, which aims to restore the body's ability to regulate glucose by providing patients with pancreatic islet cells derived from donor stem cells to produce insulin to replace insulin injection therapy and long-term care. The safety of this therapy is similar to that of typical immunosuppressive therapy, and no serious side effects related to the treatment have been reported. Although there is only one patient's successful case, this is still enough to prove the feasibility of this therapy.
Encapsulated stem cell-derived islets could shield β cells from the immune system (source: reference )
In recent years, stem cell technology has been widely used in the intervention and treatment of diabetes. As a cutting-edge technology in the clinical treatment of diabetes, stem cell technology has attracted widespread attention. Many hospitals have accumulated a lot of experience in rich clinical applications. How do stem cells work in the treatment of type 1 diabetes?
The mechanism of stem cell therapy in the treatment of diabetes
Stem cell therapy is currently recognized as the ultimate hope for a radical cure for diabetes. Mesenchymal stem cells can secrete a variety of immunoregulatory factors and nutritional factors to restore and repair a variety of damaged tissues. Due to easy separation and low immunogenicity, mesenchymal stem cells are currently the most widely used stem cells in clinical practice.
1. Type 1 diabetes and stem cells
Type 1 diabetes is an autoimmune response mediated by T cells, which leads to a lack of pancreatic islet cells. The reason why it is difficult to overcome is due to the polyclonal characteristics of the autoimmune response of type 1 diabetes and the characteristics of multiple immune regulation disorders. Therefore, how to effectively control autoimmunity is a key problem to be solved urgently in the treatment of type 1 diabetes. The treatment shows that stem cells have immunomodulatory effects. Using the immunomodulatory effect of stem cells to correct the autoimmunity of type 1 diabetes has been clinically applied and achieved remarkable results as a novel therapy.
2. Type 2 diabetes and stem cells
The occurrence of type 2 diabetes is closely related to the significant decrease in the sensitivity of insulin receptors in peripheral tissues, which leads to a decrease in the utilization of blood sugar by tissue cells, and ultimately manifests as a significant increase in blood sugar levels that are common in clinical practice. Mesenchymal stem cells have strong migration and differentiation ability and can secrete a variety of good cytokines. These factors can stimulate mesenchymal stem cells to exert immunosuppressive functions, and a large number of well-grown stem cells can promote the survival of damaged cells in a short time. Treatment with mesenchymal stem cells takes advantage of their supportive role in secreting multiple cytokines and their ability to differentiate into vascular endothelial cells.
Disadvantages of traditional treatments for diabetes
Diabetes is a group of metabolic diseases characterized by hyperglycemia. Hyperglycemia is caused by defective insulin secretion or impaired biological effects, or both. The prolonged presence of hyperglycemia in diabetes leads to chronic damage and dysfunction of various tissues, especially the eyes, kidneys, heart, blood vessels, and nerves. There are generally two traditional methods of diabetes treatment, both of which have obvious disadvantages.
One is the drug therapy. Although oral medications and insulin injections can improve symptoms, they cannot precisely regulate blood sugar, reverse insulin resistance and β cell dysfunction, reduce tissue and organ damage, and fundamentally treat diabetes.
The other one is transplantation of pancreas and islets. This kind of treatment is expensive and the donors are very limited. It requires long-term administration of immune preparations. It has large side effects, low operability, and cannot be widely used.
Compared with traditional treatments for diabetes, stem cell therapy is to repair one's own pancreatic islet function and improve the symptoms of diabetes. With the stem cell treatment, about 65% of patients have gotten rid of their dependence on insulin or oral medications. More than 90% of patients have reduced the application dose of insulin or oral drugs, or changed the injection of insulin to oral drug therapy, which greatly controlled or slowed down the occurrence and development of complications.
Advantages of stem cell therapy for diabetes
◆Stem cell therapy can make diabetic patients stop using insulin or reduce insulin dosage.
◆The safety of stem cell therapy in the treatment of diabetes has been effectively tested.
◆Stem cell therapy can effectively control fasting blood glucose, postprandial blood glucose and hemoglobin (HbA1c) and other biochemical indicators.
◆Stem cell therapy can effectively prevent diabetic complications, such as diabetic foot.
The treatments showed that insulin-producing cells can be obtained from stem cells. Stem cells represent an infinite source of cells and solve the problem of lack of donors. Diabetes is a metabolic disease caused by the disorder of autoimmune processes. Only by solving the original causes and mechanisms can the problem be solved. With the development of scientific research, stem cell treatment of diabetes will make greater breakthroughs.
Stem cell technology is widely used now. In addition to treating diabetes, it can also be used in muscle tissue regeneration, certain eye diseases, heart diseases, etc. In the future, stem cell technology can also be used to cultivate organs in vitro.
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 First time: Stem cells successfully treat diabetic patients to regenerate insulin
 Vertex Announces Positive Day 90 Data for the First Patient in the Phase 1/2 Clinical Trial Dosed With VX-880, a Novel Investigational Stem Cell-Derived Therapy for the Treatment of Type 1 Diabetes
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 How stem cells could fix type 1 diabetes