Eleven million euro for transplantation for type 1 diabetes
People with type 1 diabetes can now produce insulin themselves thanks to the transplantation of islets of Langerhans. Because there is a shortage of organ donors and it is difficult to use these islets optimally, this treatment is only available for a small group of patients. A sum of 11 million euro has been made available to develop this cell replacement therapy further and to make it available for a larger number of patients. A large part of the funds has come from the Economic Structure Enhancing Fund (FES) in the context of the Topinstituut Gezond Ouder, Ti-GO.
The funds will be used to carry out research into the use of biomaterials to improve transplantation of islets of Langerhans. Research is also planned into better storage of donor organs between removal and transplant and into factors that can promote the survival of insulin-producing cells. The findings of this research programme are not only intended to benefit the present group of diabetes patients who are considered for transplantation. 'The programme also focuses on the future, on whether it will be possible to grow islets from stem cells,' explains specialist in internal medicine Eelco de Koning, who is responsible for the islets of Langerhans transplantation programme in the LUMC. 'The co-operation of many different parties is what makes this ambitious programme possible.' Finally, part of the funds will be used to further develop the special facility for cell therapy in the LUMC. In this facility, islets of Langerhans are isolated from the pancreas of donors.
Once they have been isolated from a donor pancreas, the islets are transplanted into patients suffering from type 1 diabetes by inserting a drip into the portal vein to the liver where the islands lodge and start producing insulin. Unfortunately many of the transplanted islands die off. This is why islets from several donor pancreases are needed to achieve a good resut in patients. A reason for this is that the islets do not become absorbed quickly enough into the bloodstream of the recipient. 'They starve,' says Marcel Karperien of the MIRA Institute of the University of Twente. ‘So we have to make sure there is a more rapid blood supply. We want to improve this situation and consequently raise the success rate by using biomaterials.'
By improving cell replacement therapy in diabetes patients, more efficient use can be made of the present limited availability of donor organs, which will allow more diabetes patients to be treated. Bert Kuipers, director of the Diabetes Foundation, commented: 'We asked patients what they thought of this research. This is a unique and useful step in selecting good research. What I particularly noticed is that they have a very clear understanding that this offers opportunities for the future. They also realise how few people are currently considered for a transplant.'
The research programme of this Diabetes Cell Replacement Therapy Initiative (DCTI) will be carried out by a consortium of three academic centres: the Leiden University Medical Centre (LUMC), Twente University and the Groningen University Medical Centre (UMCG). A number of biotechnology companies are also involved in the research, including Biofocus, Polyganics BV and Xpand Biotechnology BV, and the research is supported by the Diabetes Foundation. The DCTI is part of Topinstituut Gezond Ouder (Ti-GO). On the basis of a proposal by the Ministry of Health, Welfare and Sport, the Cabinet has decided to provide the DCTI with funding of 7 million euro from the FES. In addition to the one million euro from the Diabetes Foundation, the participants in the DCTI will contribute a further 3 million euro themselves.
Insulin-producing cells are part of the islets of Langerhans in the pancreas. In type 1 diabetes there is a disturbance in the function of these islets whereby the glucose level in the blood is raised. In the case of type 1 diabetes (adolescent diabetes), the insulin-producing cells are even totally destroyed. To survive, patients with this type of diabetes have to have injections of insulin to reduce their blood sugar level. In spite of insulin therapy, patients have a much higher risk of heart attacks, strokes, blindness and kidney failure. Replacement of the insulin-producing cells can be achieved by transplantation of the pancreas. However, this is a serious procedure. The LUMC has therefore recently announced the development of a new, less radical form of cell replacement therapy: transplantation of islets of Langerhans.
Research profile area
Vascular and Regenerative Medicine
Previous articles in the University Newsletter
First transplantation of islets of Langerhans (18 December 2007) (in Dutch)
(11 November 2009/LUMC)