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United Nations Diabetes Day
is celebrated on 14 November every year.
Formerly known as World Diabetes Day' WDD, the United Nations Diabetes Day was jointly launched by the World Health Organization and the International Diabetes Federation in 1991 to raise global awareness and awareness of diabetes
.
Diabetes is one of the fastest growing health problems of the 21st century, with the number of adults living with diabetes more than
tripling from 20 years ago.
Preventing and controlling diabetes remains a top priority, and this year's theme is: Diabetes: education to protect tomorrow
.
In a study from Stanford Medical School today, after transplanting insulin-secreting islet cells, mice with diabetes appeared to cure the disease
.
The researchers say that before transplantation, the animals' immune systems are induced to accept donated cells through a three-pronged process, a process that is easily replicated
in humans.
Immunosuppressive therapy is not required after transplantation to prevent rejection
of foreign islet cells.
Seung Kim, MD, professor of developmental biology, said: "Clinically, this result is very promising
.
" "There are many diabetics in the world who will benefit
from receiving islet cells.
"
The problem is that islet transplantation requires chronic immunosuppression, most commonly drug suppression, to prevent rejection
.
To avoid this, methods have been developed to reset and prepare the immune system of the transplanted recipient, but these methods often include high doses of radiation and chemotherapy, which are too
toxic for most people with diabetes.
"Our study shows that it is possible
to use unrelated donors and avoid the toxic pretreatment methods required," Kim said.
Kim is director of the Stanford Center for Diabetes Research and the JDRF Center of Excellence, and senior author of the study, published Nov.
8 in
Cell Reports.
The study's lead authors are former postdoctoral scholar Charles Chang, Ph.
D.
, and graduate student Preksha Bhagchandani
.
"The publication of Dr.
Kim's findings provides evidence for ways to promote graft islet tolerance without suppressing systemic immunity," said
Esther Latres, Ph.
D.
, vice president of research at JDRF, a global funding organization dedicated to ending type 1 diabetes.
The implications of the findings extend far beyond diabetes
.
The technology, which builds on earlier work at Stanford School of Medicine, could open the door to a new type of organ transplant that doesn't require an immune-matched donor or years of immunosuppressive drugs
.
The trick is to do two transplants instead of one
.
Years ago, researchers at Stanford School of Medicine, including Samuel Strober, M.
D.
, professor of immunology and rheumatology, replaced the recipient's immune system with the recipient's immune system with the donor's immune system before an organ transplant through a process called blood stem cell transplantation, ensuring that the organ was seen as "self" and not rejected
by the body.
(It's also a treatment for blood and immune system cancers, such as leukemia and lymphoma
.
) )
However, the high-dose radiation and chemotherapy necessary to kill the recipient's blood stem cells carries a huge, potentially fatal cost and often results in infertility
.
It also creates the conditions for the new immune system to attack other healthy tissues and organs it deems foreign—a condition known as graft-versus-host disease
.
Further research by Strober and other researchers, including study co-author Judith Shizuru, MD, professor of medicine, suggests that it is possible to hinder, rather than eliminate, the recipient's immune system
before the donor's stem cells are introduced.
The result is a hybrid immune system consisting of donor and recipient stem cells and reducing the likelihood of
graft-versus-host disease.
Mixed or chimeric immune systems are also less likely to reject transplanted organs, especially if immune
matches are good.
In 2020, Strober and his colleagues demonstrated that most people who received perfectly matched sibling kidney transplants were able to go without immunosuppressive drugs
for at least two years.
Until now, condition-modulating protocols to achieve this chimeric immunity have been too harsh for use without endangering life, and organs must be at least partially immune matched to avoid drugs
.
In the current study, Kim and his colleagues used a three-pronged approach to prepare diabetic patients for stem cell transplants
.
They combined low-dose radiation, with one dose of an antibody called c-kit selectively targeting and killing blood stem cells (which produce immune cells) and another dose targeting mature immune cell T cells
.
They found that this was enough for the donor cells to establish themselves in the animal's bone marrow and create a fully functional, chimeric immune system without the serious side effects
seen with other methods.
These diabetic animals were able to receive islet cell transplants from stem cell donors, even though the animals' immune functions were completely mismatched
.
"We had an idea that we could get bone marrow ready to receive donor stem cells with less toxic alternatives," Kim said
.
"We found that we could reduce the radiation dose by 80 percent and replace broad-spectrum chemotherapy drugs
with targeted antibodies.
The animals quickly regained the weight they lost due to the disease and were able to maintain normal blood sugar levels until the end of the study more than 100 days later
.
”
If we succeed, we could see a future where we can treat people with diabetes at an early stage, preventing or alleviating their lifelong health problems
.
These mice were no more susceptible to infection than control mice, suggesting that their immune systems were functioning properly and that they were able to reproduce and give birth to healthy pups
.
"There are many reasons why this is exciting," Kim said
.
"This approach can be applied to autoimmune diabetes, including type 1 diabetes, and shows that completely mismatched islet cells can be used for transplantation
.
" In addition to diabetes, it is also important
for solid organ transplantation.
”
One caveat of this study is that donor stem cells and islet cells must come from the same animal, and human islet cells are difficult to obtain
.
Kim and his colleagues in the Stanford Islet Replacement and Immune Tolerance Program are investigating whether functional islet cells can be grown from pluripotent stem cells in the lab, or whether a small number of human islet cells can be grown and expanded in the lab to make more transplantable islet cells
.
"If we succeed, we can see a future where we can treat diabetics at a very young age, thus preventing or alleviating health problems
throughout their lives," Kim said.
