Thursday, February 2, 2023

Implantable device to control type 1 diabetes

A device the size of a tiny coin could vastly transform the treatment of type 1 diabetes, a chronic disease that affects millions of people and still has no cure.

Type 1 diabetes is caused by an autoimmune response that destroys the cells in the pancreas that produce insulin. This can also cause kidney failure. Daily insulin injections are the most conventional treatment, but achieving tight control of glucose levels remains difficult and burdensome for patients. Furthermore, in the most severe cases, patients may require pancreas and kidney transplants. Another option is a pancreatic islet cell transplant, in which islet cells taken from the pancreas of a deceased donor are processed and transplanted into the liver of a patient with type 1 diabetes.

These implants can help ease a patient’s symptoms; However, like all organ transplants, one of the biggest challenges is the need to take immunosuppressive drugs for the rest of your life to prevent transplant rejection. Lifelong immunosuppression can make patients more vulnerable to infectious diseases and increase the risk of certain types of cancer.

A team led by Alessandro Gratoni and Jesus Páez-Mayorga from the Methodist Hospital Research Institute in Houston, Texas, USA, has succeeded in incorporating islet cells and immunotherapy directly into a 3D-printed device, which in some cases can serve as an artificial pancreas. Is equal to. , and called NICHE (Neovascularized Implantable Cell Homing and Encapsulation).

Treatment with this device restored healthy glucose levels and eliminated symptoms of type 1 diabetes in animal models for more than 150 days, while avoiding the serious adverse effects of anti-rejection therapy by delivering immunosuppressive drugs only Can be traced to where the cells were found. ,

NICHE, created at the Department of Nanomedicine of the aforementioned institute, is a flat device that is placed under the skin and contains a reservoir for islet cells and drugs for local immunosuppression therapy. This is the first platform to combine direct vascularization and local immunosuppression in a single implantable device for allogeneic pancreatic islet transplantation and long-term treatment of type 1 diabetes. Direct vascularization is essential to deliver nutrients and oxygen to maintain the viability of the transplant. Is. Islet cells.

The new device is the size of a small coin. (Photo: Houston Methodist)

NICHE includes ports for drug refilling as needed. During the trials, the researchers refilled the drug’s reservoirs every four weeks.

Gratoni’s team is already working on adapting the NICHE technology for clinical use, which includes improvements such that drug refills will only be needed once every six months, long enough for NICHE to use the technology. Very practical for patients. Furthermore, by making appropriate changes to the formulations or to the concentration of the drugs, the refilling interval can be extended up to one year, for example with regular medical visits to monitor the patient’s condition.

Gratoni and colleagues report a technical description of their device and the results of tests with it in the academic journal Nature Communications, “Implantable niche with local immunosuppression for islet allotransplantation achieves type 1 diabetes reversal in mice.” (Font: ncyt d amazing,

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