The patient has been off insulin for 33 months. Shanghai Changzheng Hospital cured a patient with a 25-year history of diabetes.
The reporter learned from the Second Affiliated Hospital of the Naval Medical University that on April 30, Professor Yin Hao’s team from the hospital and Professor Cheng Xin’s team from the Center for Excellence in Molecular Cell Science of the Chinese Academy of Sciences published an article online in the authoritative magazine CellDiscovery entitled “Treating a type 2 diabetic patient with impaired pancreaticislet function by personalized endoderm stem cell-derived is lett issue” research results. This is the first case report in the world of using autologous regenerated islet transplantation derived from stem cells to successfully cure diabetes with severely impaired islet function. The patient has been completely off insulin for 33 months.
According to reports, my country is the country with the largest number of diabetes patients, with as many as 140 million patients, of which about 40 million require lifelong insulin injection treatment. Severe patients with difficult to control blood sugar can only be effectively treated through transplantation therapy in which islet tissue is extracted from a donated pancreas and injected minimally to avoid the progression of complications. However, due to factors such as the severe shortage of donors and the complexity of islet isolation technology, it is difficult to meet current clinical needs. Therefore, how to regenerate human islet tissue on a large scale in vitro has become a worldwide academic problem and has received widespread attention.
Yin Hao, director of the Organ Transplantation Center of Shanghai Changzheng Hospital, said that after more than ten years of painstaking research, the relevant scientific research team used the patient's blood PBMC to reprogram into autologous iPSC cells, and used the world's first technology to transform them into "seed cells", that is, endodermal stem cells. Eventually, pancreatic islet tissue can be reconstructed in vitro. This technology has become mature and is a major breakthrough in the field of regenerative medicine in the treatment of diabetes.
The first beneficiary of this technology is a 59-year-old man with a 25-year history of type 2 diabetes and the development of end-stage diabetic nephropathy. In June 2017, he developed end-stage diabetic nephropathy and received a kidney transplant. However, due to the near failure of pancreatic islet function and the need for multiple injections of insulin every day, there is a great risk of serious complications of diabetes in the future.
On July 19, 2021, due to concerns about hypoglycemia and consideration of the adverse impact of poor blood sugar control on the long-term survival of the donor kidney, the patient underwent autologous regenerative islet transplantation at Shanghai Changzheng Hospital, starting on the 11th week after surgery. He was completely weaned from exogenous insulin, and his oral hypoglycemic drugs were gradually reduced after surgery, and the drugs were completely withdrawn at the 48th and 56th weeks. Key indicators such as fasting and postprandial C-peptide were significantly higher than before surgery, confirming that pancreatic islet function was effectively restored; follow-up indicators such as kidney function were within the normal range, which also suggested that this therapy can avoid the progression of diabetic complications. Overall, this is the first international human tissue replacement therapy using autologous islets to treat T2D patients with impaired islet function.
The team's chief scientist, Cheng Xin, established endodermal stem cells and their modified type EnSC for the first time in the world in 2012. It has advantages in specificity and in vivo safety in directional differentiation of pancreas, liver, etc., and is the first in vitro large-scale regeneration of islets and liver. The preferred seeds for other tissues. On this basis, Professor Cheng Xin also successfully established a large-scale directional differentiation system under GMP conditions, which can achieve large-scale production and has taken a milestone step forward in the field of overcoming diabetes.
It is reported that in addition to the first case of severe type 2 diabetes, the joint team has also successfully carried out and cured many cases of brittle type 1 diabetes. Yin Hao said that in the future, the research team will focus on research related to regenerated islet tissue derived from stem cells, and further develop "universal" regenerated islet tissue that does not require immunosuppression, thereby providing a new cure for the majority of diabetic patients who rely on insulin injections for a long time.
