Relax before the transfer
The modern approach to transplantation of pancreatic donor material, consisting in transplanting clusters of insulin–producing cells – islets of Langerhans to the patient, provides good results in the treatment of type 1 diabetes mellitus and can serve as an alternative to transplantation of an entire organ for a relatively long time.
A new method developed by researchers at the University of Pennsylvania, working under the guidance of Dr. Ali Naji, which consists in giving donor cells the opportunity to "rest" before transplantation, increases the efficiency of their work in the body of patients to levels that allow for a long period to abandon daily insulin injections.
Traditionally, islet cells isolated from the donor pancreas are immediately transplanted to the recipient. The inflammatory reaction that develops in this case is often the cause of the development of a rejection reaction. The new technique proposed by the authors – the CIT07 protocol – involves culturing isolated cells under controlled conditions for three days. This reduces the severity of the inflammatory reaction and the risk of developing a rejection reaction. Moreover, the rest period allows you to transplant fewer cells than the earlier protocol requires, for which you often have to use organ cells from two or more donors.
The authors came to these conclusions based on the results of the analysis of data obtained during a clinical trial in which 11 patients were injected with insulin-producing cell transplants in the period from 2008 to 2012 according to the CIT07 protocol. The results of monitoring the condition of these patients were compared with the results of monitoring 5 patients of the control group who underwent transplantation of insulin-producing cells in the period from 2002 to 2003 according to the traditionally used Edmonton protocol.
Despite the smaller number of transplanted cells, a year after transplantation, all patients in the experimental group dispensed with daily insulin injections. At the same time, in 9 of them who came for examination on the 365th day after surgery, the indicators of the arginine test (an increase in the level of glucagon in the blood after administration of arginine) were comparable with the corresponding indicators recorded on the 75th day after cell transplantation. This indicates the preservation of the functionality of the cell mass in the recipient's body.
At the same time, out of 5 patients in the control group, only one continued to do without insulin injections a year after transplantation. One of the patients in this group was forced to return to insulin replacement therapy almost immediately after transplantation, another – after 9 and two – after 11 months.
According to the authors, the fact that donor cells "rested" according to the new protocol are able to take root in the recipient's body and meet his insulin needs for at least a year gives great hopes that over time cell therapy will allow patients with type 1 diabetes mellitus, currently forced to regularly measure the level of glucose in the blood and several times a day to inject yourself with an insulin drug, lead a full life.
Article by M.R. Rickels et al. Improvement in Beta-Cell Secretory Capacity After Human Islet Transplantation According to the CIT07 Protocol is published in the journal Diabetes.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on the materials of ScienceDaily:
Islet Cell Transplant Procedure Offers Improved Outcomes for Type 1 Diabetes.
24.09.2013