{"id":43908,"date":"2016-02-09T00:00:00","date_gmt":"2016-02-09T05:00:00","guid":{"rendered":"https:\/\/asweetlife.org\/islet-cell-transplantation-right-under-the-skin\/"},"modified":"2016-09-13T09:12:54","modified_gmt":"2016-09-13T13:12:54","slug":"islet-cell-transplantation-right-under-the-skin","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=43908","title":{"rendered":"Islet Cell Transplantation Right Under the Skin"},"content":{"rendered":"<p style=\"text-align: justify;\">Dr. James Shapiro, the man who perfected the islet cell transplant to cure type 1 diabetes, is evolving his groundbreaking research by working on a method of implanting insulin-producing cells under a person\u2019s skin to try and stamp out the condition once and for all.<\/p>\n<p style=\"text-align: justify;\">\u201cWe have cured diabetes in mice 91 percent of the time we\u2019ve done this procedure,\u201d says Dr. Shapiro, Canada Research Chair in Transplantation Surgery and Regenerative Medicine in the University of Alberta\u2019s Faculty of Medicine &amp; Dentistry.<\/p>\n<p style=\"text-align: justify;\">The procedure involves implanting insulin-producing islet cells under a patient\u2019s skin. According to the theory behind the procedure, once implanted the cells essentially take root and produce insulin in the same way as islet cells do in the pancreas of a person without diabetes. The manner in which the cells are transplanted under the skin however, is quite novel.<\/p>\n<p style=\"text-align: justify;\">Implanting islet cells, or any cells, under the skin and setting them free to multiply and\/or be productive has long stood as a medical challenge because the required network of blood vessels allowing the cells to circulate among the body\u2019s systems is lacking. Shapiro and his team solved this seemingly vexing problem in a simple way.<\/p>\n<p style=\"text-align: justify;\">In the article, \u201c<a href=\"http:\/\/www.nature.com\/nbt\/journal\/v33\/n5\/full\/nbt.3211.html\">A prevascularized subcutaneous device-less site for islet and cellular transplantation<\/a>,\u201d announcing the results of the study and published in the journal <a href=\"http:\/\/www.nature.com\/index.html\">Nature<\/a>, Shapiro and his colleagues describe the implantation procedure into a \u201cprevascularized, subcutaneous site created by temporary placement of a medically approved vascular access catheter.\u201d<\/p>\n<figure id=\"attachment_38688\" aria-describedby=\"caption-attachment-38688\" style=\"width: 300px\" class=\"wp-caption alignright\"><a href=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2016\/02\/Shapiro.png\" rel=\"mfp\"><img decoding=\"async\" class=\"size-medium wp-image-38688 lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-src=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2016\/02\/Shapiro-300x209.png\" alt=\"Dr. James Shapiro\" width=\"300\" height=\"209\" \/><\/a><figcaption id=\"caption-attachment-38688\" class=\"wp-caption-text\">Dr. James Shapiro<\/figcaption><\/figure>\n<p style=\"text-align: justify;\">In plainer words, Shapiro put a tube under the skin to grow blood vessels.<\/p>\n<p style=\"text-align: justify;\">\u201cWe inserted a nylon, plastic, five-inch catheter under the skin for a few weeks,\u201d Shapiro says. \u201cThis induced the growth of a network of blood vessels at the site. We removed the catheter [hence the \u201cdevice-less\u201d aspect of the procedure] and implanted the cells.\u201d<\/p>\n<p style=\"text-align: justify;\">This latest innovation marks a possible improvement over the Edmonton Protocol, Shapiro\u2019s previously heralded procedure for successfully implanting islet cells into type 1 diabetics.<\/p>\n<p style=\"text-align: justify;\">Developed at the University of Alberta, in Edmonton, the Edmonton Protocol involved harvesting islet cells from cadaver pancreases and implanting them into a subject\u2019s liver. After transplantation, subjects undertake a regime of immunosuppression similar to those who receive an organ transplant, to keep the body from rejecting the cells.<\/p>\n<p style=\"text-align: justify;\">While revolutionary when the procedure was developed in the 1990s and first reported in 2000, by <a href=\"http:\/\/www.citregistry.org\/\">2010 it was apparent<\/a> that most of the subjects <a href=\"https:\/\/asweetlife.org\/feature\/curing-diabetes-would-i-do-it-again-2\/\" target=\"_blank\">who received islet cell transplantation had to begin taking insulin again a year after they received the transplant<\/a>.<\/p>\n<p style=\"text-align: justify;\">Aside from the disappointing long-term success rate, islet cell transplantation using the Edmonton Protocol had other drawbacks. The first is that human islet cells are very expensive and difficult to acquire because they come from donor pancreases and, in many cases, subjects who receive transplants need islet cells from multiple donors. Another problem, <a href=\"https:\/\/uofa.ualberta.ca\/news-and-events\/newsarticles\/2015\/april\/researchers-get-under-the-skin-to-develop-new-transplant-technique\">according to Shapiro<\/a>, is that \u201cWhen we put islets in the liver, most of them get destroyed in a matter of minutes to hours, and we don\u2019t have a very good way to stop that.\u201d Additionally, the immunosuppression regimen required not only causes sometimes debilitating side effects unrelated to diabetes but, <a href=\"http:\/\/weill.cornell.edu\/news\/pr\/2007\/03\/researchers-report-successful-islet-cell-transplant-without-immunosuppressive-therapy-in-mice-with-t.html\">according to some researchers<\/a>, may harm the islet cells over time.<\/p>\n<p style=\"text-align: justify;\">Shapiro, however, doesn\u2019t see the Edmonton Protocol as a step back, but as a step forward when placed in the larger context of efforts to cure type 1 diabetes.<\/p>\n<p style=\"text-align: justify;\">\u201cWhen we try something new it\u2019s important to realize that it\u2019s not finalized,\u201d he says. \u201cEverything we do is a step toward an answer. Some of those are leaps, and some are baby steps, but they all move us forward.\u201d<\/p>\n<p style=\"text-align: justify;\">Knowing that the Edmonton Protocol was only a step on the trail, and not the end of the line, is what led Shapiro to develop the device-less method for implanting islet cells.<\/p>\n<p style=\"text-align: justify;\">\u201cI woke up one day 12 years ago wondering if there was a better place to place islet cells in the human body,\u201d Shapiro says. \u201cI thought about how vascular tissue forms on sponges left in patients after surgery. And that led to a lot of experimentation.\u201d<\/p>\n<p style=\"text-align: justify;\">Shapiro and his team worked with a whole series of tubes trying to entice blood vessel growth, and kept trying new ones until they found an answer.<\/p>\n<p style=\"text-align: justify;\">While the new procedure represents significant progress in curing, or improving the treatment of type 1 diabetes, it also holds out benefits for people suffering from other conditions.<\/p>\n<p style=\"text-align: justify;\">\u201cThis exciting new approach doesn\u2019t have to be limited to diabetes,\u201d Shapiro said in a <a href=\"https:\/\/uofa.ualberta.ca\/news-and-events\/newsarticles\/2015\/april\/researchers-get-under-the-skin-to-develop-new-transplant-technique\">University of Alberta news release<\/a>. \u201cFor any area of regenerative medicine that requires replacing old cells with new\u2014and there\u2019s lots of different disease states where there\u2019s just one gene defect that could be corrected by a cell transplant\u2014this opens up an incredible future possibility for successful engraftment beneath the skin.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr. James Shapiro, the man who perfected the islet cell transplant to cure type 1 diabetes, is evolving his groundbreaking research by working on a method of implanting insulin-producing cells under a person\u2019s skin to try and stamp out the condition once and for all.<\/p>\n","protected":false},"author":4,"featured_media":43909,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"image","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1446,1445],"tags":[246],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.9 (Yoast SEO v22.9) - 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