Pathway to a cure  pg. 3

The breakthrough report came in July 2000 from a group at the University of Alberta in Edmonton, Canada. Dr. James Shapiro and colleagues announced that each of seven islet transplant recipients — patients with type 1 diabetes and a history of severe hypoglycemia — were insulin independent, the longest for 15 months and counting. Their strategy used a novel combination of non-steroid immunosuppressant drugs — ones that were kinder to the fragile islets and that were less likely to induce insulin resistance in the transplant recipients. And it used islets from two, and in one case three, donor pancreases.

The Edmonton group “made a leap forward in terms of immunosuppression and standardization of islet isolation techniques, culminating in a very high success rate,” says Dr. Christopher Marsh, chief of the organ transplantation service at the Scripps Clinic in La Jolla, Calif., and co-director of the Organ and Cell Transplantation Center at Scripps Green Hospital.

Christopher V.E. Wright, Ph.D., (left) and Yoshio Fujitani, Ph.D., senior post-doctoral fellow, discuss their mouse embryo research. They have used genetic manipulations to introduce an inherited marker—a blue color that can be followed in cells that turn on the p48 gene and form the pancreas (shown on computer screen).
 
Photo by Anne Rayner
The approach, now known as the “Edmonton protocol,” triggered a surge in interest in islet cell transplantation and prompted the National Institutes of Health and the Juvenile Diabetes Research Foundation (JDRF) to fund larger clinical trials of the protocol and variations of it.

Since the Edmonton group’s original publication, more than 150 patients worldwide have received islet transplants as part of these trials, according to the JDRF.

Preliminary results from at least one JDRF-sponsored transplant center support the idea that islets from a single donor pancreas might even cure diabetes. Using one cadaveric pancreas per diabetes patient would stretch the islet supply, but not enough to provide islet transplantation to all the patients who could benefit from it.

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