From Alaska, USA:
I don't know about transplanted cells from another organism/person, but it seems to me that the news about cloning should enable the production of islet cells compatible with each individual. Healthy islet cells from a human and DNA from each individual (customized cells) needing a transplant, cells replicate into a mass for implantation and there it goes (I know that it is not this simple). Will the body continue to destroy the healthy cells? I believe that this is possible but not likely, the body has been exposed to so many types of insulin since the diabetic has been self injecting that it will no longer look at its own manufactured insulin as foreign. Perhaps this is being looked at, and I'm sure that it will be.
I imagine that the publicity around Edinburgh's 'Dolly' the sheep has fired your imagination. As I understand your question, what you propose is to take a normal non-diabetic islet cell and substitute its nucleus with one from the recipient, and to then culture this cell until you had enough clones for a transplant.
There are several problems with this idea, let me enumerate some of them.
- You would of course need to do a biopsy on a normal person to get a normal islet cell.
- If you succeeded in installing a recipient's cell nucleus in the normal islet cells and, in addition, were able to induce multiplication, the surface antigens of the daughter cells would reflect the genetic instructions of the recipient's nucleus. In other words, the cultured cells would be still vulnerable to attack by the recipient's lymphocytes. You would in fact be better off with an islet allograft (from another person), even then the chances of being insulin independent one year later are only 7%, or if you can get into a recent protocol developed in Germany, as high as 25%. In other words, you are much better off using the latest in new insulins, new syringes and new meters and using some form of intensive insulin therapy.
- No one has yet succeeded in getting islet cells to multiply in culture.
Tansplants have quite a lot to offer if a person has end stage renal disease and both a kidney and a pancreas transplant can be done at the same time; but there is a long way to go still before islet cell transplants can become a substitute for conventional insulin therapy.
Additional Comment from Dr. Lebinger:Although I can't give you an exact answer to your question about what incentive do the pharmaceutical companies have in finding a cure, I would like to offer my thoughts.
I don't think it is the responsibility of the pharmaceutical companies to find a cure for diabetes. Their responsibility is to help provide the means to obtaining the best possible control so people with diabetes will be healthy when the cure is found.
I suggest you contact you congressman and senator to encourage the government to appropriate more money towards diabetes research. Increased public awareness of the complications of diabetes will also help convince private foundations of the need to support diabetes research. We all should individually support the American Diabetes Association, the Juvenile Diabetes Foundation, and other institutions in their fundraising campaigns to support diabetes research.
We all look forward to the cure.
Original posting 28 Mar 97
Additional comment added 7 May 97
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