Thursday, April 25, 2013

Diabetes demystified: the role of stem cells in finding treatments

Today Harvard's stem cell scientists announced finding a hormone that could lead to a therapy for type 2 diabetes (we blogged about that here). That's big news for the 26 million people in the U.S. with the disease.

The question I've heard is how this relates to the stem cell agency's investment in a type 1 diabetes therapy being developed by ViaCyte in La Jolla, CA. So far we've committed almost $40 million to ViaCyte's technology, which they hope to start testing in patients in the next year or two. Here's a list of those awards.

In type 1 diabetes (often called juvenile diabetes), the body's immune system attacks and eventually destroys the cells of the pancreas that produce insulin. Without insulin, cells in people with the disease can't take up sugar from the bloodstream and use it for fuel. They rely on injected insulin to survive. In this video, Sarah Young and Chris Stiehl explain what it means to live with the disease.

ViaCyte has developed a way of maturing embryonic stem cells into pancreatic cells that produce insulin. They then put those cells into a device that will protect them from the body's immune system. They hope to implant that device under the skin, where it will act like a small pancreas, producing insulin on demand. So far, it works as expected in animals.

ViaCyte shared this image with us, which shows a side view of their cells within the flattened pouch.

By contrast, people with type 2 diabetes still make insulin, but they don't make enough for all the body's cells to be able to take up sugar from the blood. Early in the disease, they can take drugs that help the body's cells use the insulin that's available, but over time most end up needing to inject additional insulin. Harvard's discovery, if it proves to be as effective as it seems, would expand the number of pancreatic cells that produce insulin, helping those people produce enough insulin without needing injections several times per day.

The two approaches come at the disease from two different sides: one bumping up the number of existing pancreatic cells, the other implanting new pancreatic cells to replace those that are lost. Given that the American Diabetes Association estimates that the total yearly cost of diabetes in the U.S. is $245 billion, we need as many good approaches as possible to help all people with the disease.

Here's more about all of CIRM's diabetes commitments.


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