My child, age 5, was diagnosed 6 months ago with type 1 and is currently in the honeymoon phase. Is there any merit to extracting some of her still functioning islets for preserving, and later cloning and re-injecting when a possible immune tolerance type cure can be realized to avoid graft-vs.-host-disease?

The short answer to your question is ‘No’. Even supposing that you could isolate some active insulin producing beta cells either by biopsy or surgical removal of the tail of the pancreas and could then replicate them by whatever means, they would still preserve the genetic bias that provoked the autoimmune process in the first instance. In a way this is what happened when transplants from identical twins were carried out years ago and failed.

Nonetheless what you suggest may one day be possible especially as there are now significant hopes for what you call immune tolerance cures. I expect though that as these immunomodulatory procedures like vaccination with insulin linked to the mucosal carrier protein, B chain fragments, isoforms of Glutamic acid decarboxylase and DiaPep277 are explored they will be targeted at genetically high risk subjects, prediabetics or those with LADA (Late Autoimmune Diabetes in Adults) rather than at established diabetics as a preliminary to some form of transplantation. If you have access to a medical library you might be able to look at a good review of this theme in Diabetes Reviews, Volume 7, no 3, page 154, 1999.

In the meantime I think that you can look forward to some kind of external artificial pancreas in which a glucose sensor is safely linked to a pump and there is always a hope for islet cell transplantation. One of the latest prospects being explored in New Zealand is one in which porcine islets are pretreated with nicotinamide and the encapsulated for intraperitoneal injection. If this worked it could be relatively inexpensive and there would be plenty of available tissue.

DOB