The researchers implanted a bioreactor containing human islet cells into the body of a type 1 diabetes patient. These islet cells in the artificial pancreas system successfully produced insulin for almost a year. The research team led by Professor Dr. Stefan R. Bornstein, director of the Medical Clinic III of Dresden University Hospital, has now published the results of this successful therapy in the renowned scientific journal Proceedings of the National Academy of Sciences (PNAS 2013; doi:10.1073/pnas.1317561110). The novel therapy and the pancreas system may eliminate the need for immunosuppressive drugs to prevent graft rejection. However, further studies are required before a larger number of patients can benefit from this innovative therapy.
Researchers at Dresden University Hospital achieved a world’s first by implanting an artificial pancreas system in which islet cells – just like in the pancreas – produce the vital insulin in a type 1 diabetes patient. The small bioreactor, shaped like a flat tin, remained in the body of the patient for almost one year. Its special feature: the artificial pancreas system – developed by an Israeli company – does not require immunosuppression, unlike other organ and tissue grafts. The bioreactor allows insulin to be secreted into the body, but at the same time protects the donor cells from attack by the immune system. Professor Bornstein, director of the Medical Clinic III at Dresden University Hospital: “The ‘Egg of Columbus’ is the controlled oxygenation of the cells, which thereby remain active.” Professor Bornstein is convinced that the new system has the potential to revolutionize diabetes treatment.
In the future, even xenotransplantation with insulin-producing cells from pigs could be used without being rejected by the human immune system. “If the recipients of donor cells would no longer have to take immunosuppressive medication for the rest of their lives and if we could circumvent the problem of the shortage of donor organs, many more people than in the past could benefit from islet cell transplantation,” Bornstein added.
“The world’s first use of a bioreactor in a diabetic patient is further evidence for the successful combination of cutting-edge medicine and science in Dresden. It is the result of a strategy whose foundation was laid with the establishment of the university medical center in Dresden exactly 20 years ago,” said Professor Michael Albrecht, medical director of the Carl Gustav Carus University Hospital. “These impressive results illustrate our objective to implement basic research findings for the benefit of patients – one of the main goals of the medical faculty in Dresden,” said Prof. Dr. Heinz Reichmann, dean of the Carl Gustav Carus Medical School, Technical University of Dresden.
For Professor Andrew V. Schally, Nobel laureate in medicine from the Miller School of Medicine of the University of Miami, which collaborates with the Dresden research team, this breakthrough is of “historic significance“. For people with type 1 diabetes, who despite drug therapy suffer from life-threatening fluctuations of their glucose metabolism, the transplantation of the pancreas and islet cells are currently the only possibilities to replace the insulin-producing beta cells. Both options lead to significantly improved diabetes control and quality of life for those affected. However, the long-term use of immunosuppressive drugs makes the patients vulnerable to infections or to other possible adverse effects such as increased cancer risk. That is why islet cell transplantation has thus far only come into question for people who meet very specific medical criteria.
In 2008 Dr. Barbara Ludwig established the islet program of the Medical Clinic III at Dresden University Hospital, which is the only active center for islet transplantation in Germany and is integrated into the research program of the German Center for Diabetes Research (DZD). The focus of Dr. Ludwig’s research is on improving the quality of the islet cells. Together with Israeli colleagues, she first comprehensively tested the artificial pancreas system on animal models before the first clinical application took place. The results of this study have now been published in the renowned journal PNAS (Proceedings of the National Academy of Sciences): PNAS 2013; doi:10.1073/pnas.1317561110. However, before more people can benefit from the Dresden research achievement, further studies and developments are needed. “We estimate that the system will be a therapeutic option in the treatment of diabetes within five years’ time,” said Professor Bornstein.
A 3D animation of the bioreactor can be found at: http://www.youtube.com/playlist?list=PLxfoFLLl3pz8a4-EERSw4-6kHSdChCeO_
Alternative link to the 3D animation of the bioreactor: http://www.youtube.com/watch?v=0J9gzOrg3JE&list=PLxfoFLLl3pz8a4-EERSw4-6kHSd...