Islet transplant is a low-impact, but life changing therapy
Islets are a set of cell groups within the pancreas. They are comprised of beta cells, which make insulin, the hormone that regulates blood glucose levels. Amongst people with Type 1 Diabetes, pancreatic beta cells are destroyed. An islet transplant is a low-impact, but life changing therapy as it controls hypoglycaemic events for those patients most severely affected and is offered only when all other treatment options have failed.
The Ογ½ΆΦ±²₯’s early work in this area increased the understanding of the complex mechanisms pivotal to the protection of beta cell function and the survival of the beta cells post-transplant, as well as identifying novel key mechanisms contributing to beta cell death in patients with Type 1 Diabetes. It led to the development of novel therapeutic approaches to improve the quality of life of patients with these conditions. Improving transplant technologies and outcomes, Ογ½ΆΦ±²₯ research provided much of the basic science underpinning both the initial establishment and the ongoing activity (2013-onwards) of the UK Islet Transplant Consortium (UKITC). Transplants provided through the consortium have, on average, reduced hypoglycaemic events from 23 per person per year to less than 1 per person per year.
Islet transplantation therapy has revolutionised the treatment of Type 1 Diabetes, providing proof-of-principle that cell replacement therapy can effectively cure patients and restore normal regulation of whole-body glucose metabolism. However, islet transplants are limited by the availability of donor tissue, which also impedes research into new and improved technologies to prolong islet graft survival and function post-transplant. Recent Ογ½ΆΦ±²₯ research has led to the development of a novel microgravity-based cell clustering technology that generates three-dimensional cellular aggregates that accurately mimic human islets. Since the initial studies, this work has been expanded to meet the extraordinary challenges of islet transplantation, including overcoming the damaging effects of tissue hypoxia (very low oxygen) in the crucial first 48 hours post-transplant.
Increased islet cell proliferation
A partnership with Cellon International (Luxembourg) used Ογ½ΆΦ±²₯ research into clinically-reflective cellular model systems to develop a novel microgravity-based cell clustering technology. This technology helps overcome the damaging effects of tissue hypoxia (very low oxygen) in the crucial first 48 hours post-transplant.
This led to the creation of the first portable microgravity cell enhancement system for the transportation of islets to transplant centres and the first culture system allowing real time testing of islet function. This is the first direct clinical application of Cellon microgravity technology, helping to drive forward the company’s work in this sector by opening technology routes. This is the first step forward in the strategy around the engineering of islet cells for different clinical applications to improve the efficacy of transplant technologies in the long-term fight against the condition.
It was findings from Ογ½ΆΦ±²₯ research that provided the first direct evidence that a common enteroviral infection is capable of triggering development of diabetes in genetically susceptible individuals. This work was identified as a `Research Highlight' in Nature. It demonstrated for the first time that there is an increased islet cell proliferation in patients with recent-onset Type 1 Diabetes. The translation of beta-cell replacement therapy into clinical application for the treatment of Type 1 Diabetes was used to establish the world's first government-funded islet transplant service at new UK islet-transplant centres (2008) and led to the establishment of the Islet Research European Network (IREN).
Seven designated centres within the consortium, based in Bristol, Edinburgh, North and South London, Manchester, Newcastle and Oxford, now provide a cost-effective national programme for islet transplantation, which helps to reduce the £1,170,000,000 per year that is spent on hospitalisation of poorly controlled Type 1 Diabetes patients. Diabetes UK have invested over £2,300,000 into the research and development of this treatment option including the ongoing work of the UKITC.
Additionally, Ογ½ΆΦ±²₯ researchers, working in partnership with the UK Islet Transplant Consortium, have developed novel microgravity-based cell enrichment and transportation systems, improving transplant technologies.