Some students I was teaching thought that this might be possible: to engineer the insulin-producing cells with a correctly functioning gene, a type of gene therapy.  While this has been a goal for researchers, and they have successfully made insulin-producing cells in the lab from embryonic stem cells, they are not appropriate for transplant because they do not release the insulin in response to glucose levels.  Plus, the immune system might still recognize these cells as foreign and destroy them.

So a new study is looking at transforming cells of the gut that don’t have a specific job yet.  These cells receive signals throughout the life of an individual to become many different types of cells that are used for normal gut function.  So could they engineer these cells to receive the signals to become insulin-producing cells?  Also, would the cells only release the insulin in response to blood glucose levels?

Two Columbia University researchers have started finding possible answers to these questions.  Once they turned off a gene that normally plays a key role in the fate of a cell, insulin-producing cells were generated.  Having cells in the gut that make insulin can be dangerous if they did not release insulin in response to blood glucose levels, but these “new” gut cells have glucose-sensing receptors to allow them to do just that. Another remarkable feature was that the gene could be turned off either early on in development, or later on in adulthood, so it wouldn’t matter how old the patient was.

The next step is to take the research that has been done on mice so far, and see if they can mimic this in humans with the use of a drug or chemical.  This method will also need to prove to be safe and more effective than current methods of treatment, not just to avoid the burden of daily injections.

Scientists from the University of Geneva have shown that alpha cells in the pancreas of mice have changed to insulin producing beta cells. In the study, approximately 5 % of the alpha cells became beta cells. The response seen only occurs in mice when the majority of the beta cells have been eliminated. If scientists can find a way to encourage human cells to transform in a similar way while preventing the immune system from destroying the new cells, even a small percentage of new beta cells could make a huge difference in the life of a diabetic.

Identification of the mechanisms that transform alpha cells into beta cells will not only help in the treatment of diabetes but can reveal insights into the ability to direct changes in other cells, including cancer.

PDF of the Article In Nature:

http://www.nature.com/nature/journal/vaop/ncurrent/pdf/nature08894.pdf

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