"The idea is to develop a safer, more effective protocol to perfect islet cell transplantation and move the procedure to the next level. There is a lot to do to make this procedure more effective and more applicable to people with type 1 diabetes in this country and worldwide, " said Dr. Jerry Nadler, chief of the Division of Endocrinology and Metabolism at U.Va. and principal investigator of the new NIH grant.
For people with type 1 diabetes, where the body's own immune system kills insulin-producing cells in the pancreas, this transplant can offer hope of a life without daily insulin injections. The procedure involves injecting millions of insulin-making islet cells from donated pancreases into the liver, where the cells begin manufacturing insulin again.
However, some patients become insulin dependent several months or years after a transplant. Patients are also required to take immunosuppressant drugs to prevent rejection of the islets- strong medications that can have toxic side effects.
Now, U. Va. physicians and researchers in the Diabetes and Hormone Center of Excellence and the Department of Surgery have been chosen to join a consortium of five academic medical centers, organized by the NIH under a $75 million grant, to develop and perform new protocols to improve the safety and long-term success of islet cell transplantation. U. Va. experts will be working with principal investigators at the University of Miami's Diabetes Research Institute.
"The data suggests that in three or four years about half of islet cell transplant patients will be back on insulin therapy," explained Dr. Kenneth Brayman, professor of surgery at U. Va. and co-investigator of the grant. "We're trying to improve results and make this procedure more efficient and durable. This consortium allows us to move islet cell transplantation forward much faster and in a more meaningful way."
The U. Va. Health System was invited to participate in the NIH islet cell consortium because of translational research by Dr. Zandong Yang and Dr. Meng Chen of the Division of Endocrinology and Metabolism into the use of a new anti-inflammatory drug called lisofylline as an immunosuppressant. This year, Yang, Chen and Nadler discovered that lisofylline prevents diabetes from coming back after islet cells are transplanted into diabetic mice. "Lisofylline shows some benefit in human islet cell function, and it is time to test this drug in clinical islet transplantation," Yang said.