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Transplants and Diabetes
Three Toronto scientists have developed an organ transplant procedure
that could, among its many benefits, reverse diabetes.
The procedure was developed by Bernard Leibel, Julio Martin and Walter
Zingg at the University of Toronto and the Hospital for Sick Children.
The story of their work began in 1978, when they delved into research
which had never before been tried. They wanted to determine if the
success rate of organ transplants would increase if the recipient was
injected with minute amounts of organ tissue prior to the transplant. The
intention was to adapt the recipient to the transplanted tissue and
thereby raise the threshold of rejection.
In the case of the diabetes experiment, this meant injecting rats with
pancreatic tissue before transplanting islets of Langerhans, small
clusters of cells scattered throughout the pancreas which produce insulin,
glucagon, and somatostatin.
In their first experiment, outbred Wistar rats were injected with
increasing amounts of minced pancreas from unrelated donor rats for one
year while a control group was left untreated. Then both the treated and
control groups received injections of approximately 500-800 islets of
Langerhans from unrelated donors. Of the five treated animals, two
became clinically and biochemically permanently normal. Six months later,
Martin examined the cured rats and found intact, functioning islets
secreting all of their hormones, including insulin. None of the controls
were cured.
Encouraged by their first results, Leibel, Martin, and Zingg decided to
repeat the experiment with rats with much stronger immune barriers
(higher levels of rejection). Seven rats out of nine were cured. "We set
up a protocol and worked patiently with small numbers," says Leibel, "but
the results are indisputable."
In addition to reversing diabetes, there are two other benefits to the
pre-treatment procedure, according to the scientists. The first is that
the pancreas produces all the other hormones of a normal pancreas, not
just insulin. The second benefit is that the transplant recipient doesn't
have to take immunosuppressive drugs, which are so toxic for diabetics.
At present, diabetics who receive a transplanted pancreas must take such
drugs for life.
The scientists eventual goal is a human trial, but they admit it will be
years before such a study is conducted. The obvious benefit for diabetics,
if human trials prove successful, would be a return to a normal life
without dietary restrictions or insulin shots. But to Liebel, the most
important reason to continue research is to eliminate the debilitating,
degenerative diseases such as kidney, eye and heart failure that
eventually plague the aging diabetic.
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