One cell regenerating
Today, a published study was widely featured in the news because researchers at Columbia University Medical Centre (NY) are evaluating the feasibility of converting adult gut stem cells into insulin-producing cells to treat diabetes.
It sounds so exciting, but honestly, it takes a very keen eye to understand what this “news” means and how emotionally involved patients should get. It’s unrealistic to be enthusiastic about every news quip that promises a cure or so cynical that as a patient, you feel too disappointed and hopeless to muster interest about anything.
There is a happy medium, which is to get involved, and informed about what’s going on in the world of diabetes research. After all, wouldn’t every type 1 patient in the world struggling to manage diabetes, including you, have one wish —the opportunity to enjoy life with (endogenous) regulated insulin secretion.
That is what this area of research is all about.
Four Columbia University scientists found that enteroendocrine* progenitor** cells were also able to generate insulin positive cells which they determined secret bioactive insulin as well as C-peptide—unexpected markers of ?-cells. (Nature Genetics). So far so good, additionally (here is the news) these insulin positive cells were able to regenerate and produce enough sustainable insulin to reverse hyperglycemia or diabetes. This study was performed on mice, not large animals or humans, which means that this scientific study and approach is in the FIRST Stage.
Dr. Domenico Accili, lead researcher for the study told me (via email), “We “taught” them [the cells] how to make insulin by removing a gene that normally blocks this process. We don’t know that the same process can be repeated in humans, but we strongly suspect that it can.” He also said that the team is attempting to find a drug that would have the same effects as the gene knockout and that “we have funding from the US Federal Government AND a drug company, but when we start human trials we’ll need much more.”
Who else is taking a GUT approach to investigate diabetes today? Interestingly, both T1 and T2 diabetes academics are giving it a lot of attention.
- enGene, a private biotechnology company based in Vancouver, Canada, has developed a technology called EG-02 which they say regenerates the body’s own ability to “produce insulin in a meal-dependent fashion, resulting in effective control of blood glucose levels.” Their technology focuses on converting the K-cells*** which are very similar to the beta-cells that produce insulin, to function as insulin producers. (This is different from the progenitor cells sited in the news today.) enGene’s EG-02 technology is in advanced pre-clinical development, and its efficacy has only been studied in small and large animal models. Next step – human studies – please.
- The team at UBC’s Department of Physiological and Cellular Sciences are leading how the modification of K-Cells to produce insulin can sufficiently replace insulin production by beta-cells. They are the main drivers for this research with both JDRF, (and in collaboration with the above enGene, Inc.), but because they are from academia, they are worth mentioning separately. This is one lab to watch.
- In the journal Cell (October 28, 2011), scientists at UC Berkeley studying the intestines of fruit flies discovered that when fruit flies feed, their intestines secrete insulin locally, which stimulates the intestinal stem cells to divide and produce more. They concluded that intestinal insulin seems to be the signal that makes stem cells SUPERSIZE or enlarge a person’s gut – which has some obvious relevance when an individual overeats (obesity), as well as implications for type 2 diabetes investigations and therapies —and is one of the reasons why slimming down (including bariatric surgery) is relevant for type 2 diabetes.
- Type 2 diabetes may start in the gut according to Scientists at Washington University School of Medicine in St. Louis. They determined (Cell Host Microbe, Feb. 16, 2012) that Fatty acid synthase (FAS) is required for healthy regulation of the gut and intestines. People with diabetes are usually defective in the fatty acid and without it, bad bacteria invades the colon and the small intestine, This creates inflammation, and ultimately to insulin resistance and diabetes. While this research focused on T2 diabetes, there is no question that people with T1 also suffer from intestinal inflammation.
Who knows, perhaps engineered K-cells may turn out to be promising surrogate ?-cells for the treatment of type 1 diabetes and the end of injections, or maybe it is the new progenitor cells found by the Columbia team that will become successful at eliminating hyperglycemia. Either way, it’s worth keeping your eye on any news related to this area of study.
*specialized endocrine cells, usually found in the Islets of Langerhans but also found in the gut and duodenum
**progenitor cells only replicate an unknown number of times vs. stem cells which replicate indefinitely
***K-cells secrete glucose-dependent insulinotropic peptide (GIP) in a glucose-dependent manner, which acts on pancreatic ?-cells to stimulate the rapid release of insulin after a meal. (Nature, 2007)
