She is the first in the world to suffer from type 1 diabetes and to be able to produce her own insulin. A 25-year-old woman from China has been treated for her type 1 diabetes thanks to her own reprogrammed stem cells. A technique that has allowed her for more than a year to eat sugar and produce her own insulin. The results of this pioneering experiment were detailed in the journal Cellular.
Type 1 diabetes is an autoimmune disease that appears spontaneously in children or adolescents. T lymphocytes (white blood cells) begin to identify the SS cells in the pancreas as foreign cells to the patient's body and eliminate them. However, these SS cells produce a hormone essential for regulating blood sugar: insulin. Without insulin, the concentration of glucose (sugar) in the blood is abnormally high, which leads to complications in the heart and blood vessels. Irreversible until then, the type 1 diabetes is treated with insulin treatment that patients must take for life.
An isolated but promising case
All people with type 1 diabetes, except this young woman from Tianjin in China, who was able to benefit from a transplant of her own stem cellsThese stem cells are neutral, still undifferentiated cells, which subsequently transform into specialized cells.
In the case of the young woman, stem cells were developed from already specialized cells, we then speak of induced pluripotent stem cells. Concretely, " The researchers took the patient's adipose tissue and transformed it into stem cells using a cocktail of small molecules. This is a real challenge. These stem cells were then transformed into pancreatic endocrine cells using a very specific protocol.", explains Professor Raphael Scharfmann, researcher at Inserm and pioneer in the field of pancreatic SS cells.
Thanks to these new endocrine cells in the pancreas, the patient began producing her own insulin three months after the transplant.
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While this first is encouraging in the field of research into type 1 diabetes, it remains an isolated case and does not suggest a treatment that would be available to all patients. It's not for everyone", warns Professor Scharfmann.
First, we must recall the very particular profile of this patient: "In addition to her type 1 diabetes that appeared in adolescence, she suffers from parallel pathologies, has already had a liver and pancreas transplant and is taking immunosuppressive treatment [to maximize the chances of success of the liver transplant]", explains the specialist.
The researchers themselves say they don't know exactly why the technique finally worked in this patient but never in previous trials with other patients. The key element could be the immunosuppressive treatment for her liver transplant, which would have allowed better assimilation of her own reprogrammed cells.
Perhaps the novel injection site – the abdominal muscles – also played a role, since grafts usually occur in the liver.
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Of theThe factories » high-performance insulin
Professor Scharfmann highlights the colossal work carried out on the quality of stem cells prior to the transplant. After many quality controls, they were first transplanted into more than 200 mice, which is huge. The genome of these cells was then sequenced to be analyzed and only then were they transplanted into the patient.. »
In total, 2 billion cells were transferred to him. That's twice as many as we have in the pancreas. The SS cells that produce insulin are real factories. We have 1 billion of these cells in our pancreas and each of them produces 6,000 molecules of insulin per second.. » The twice as high number of pancreatic endocrine cells may also have been a determining factor.
In any case, " This is a big step. Especially if we look at where we were 25 years ago.", comments the specialist. The team that followed this patient could well publish other results soon. The researchers said they want to extend the trial to a group of 10 to 20 other people.
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