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Advanced Cell Replacement Therapy For Diabetes Mellitus

ReLife International Medical center

At ReLife, Recent advances in molecular and cell biology may allow for the development of novel strategies for the treatment of type 1 diabetes. In particular, it is now possible to envisage restoration of insulin secretion by gene or cell-replacement therapy. The β-cell is, however, remarkably sophisticated, and many of the features of this highly differentiated secretory cell will have to be faithfully mimicked in surrogate cells. In particular, insulin is normally secreted in a well-regulated fashion in rapid response to the metabolic needs of the individual and most specifically (but not exclusively) to changes in circulating levels of glucose. Such regulated secretion will be indispensable in order to avoid both hyper- and hypoglycemic episodes and depends on the ability of cells to store insulin in secretory granules before exocytosis in response to physiological stimuli. Furthermore, any newly created insulin-secreting cell will have to be able to adapt to alterations in insulin requirements that accompany changes with exercise, body weight, and aging. Fine tuning of insulin secretion over the longer term will also be important to avoid “clinical shifting” that could be caused by over-insulinization, including increased adiposity and cardiovascular disease. Finally, it will be necessary to ensure that newly created or implanted (surrogate) β-cells are protected in some way from recognition by the immune system and in particular from autoimmune destruction.

Our intention in this article is to place these two methods in as objective a setting as possible and to set minimal standards that we feel need to be met in order to be useful in a clinical setting. It is not our purpose to write a comprehensive review of the field, and we do not wish to take sides on any of the issues discussed. Our motivation is straightforward but strongly felt

Gene Therapy

(Insulin) gene therapy will be considered as including any approach that involves the introduction of a foreign gene into any cell type in the body, allowing it to produce insulin. The gene(s) introduced could be the insulin gene itself, under control of a tissue-specific promoter, allowing for expression in a select non–β-cell type, or a gene encoding a factor that in turn activates the insulin gene, thereby allowing for ectopic insulin production. The induction of stem-cell differentiation into β-cells (or cells with an insulin-producing phenotype) by means of molecular intervention in the patient would be included in this definition of gene therapy.

Cell-Replacement Therapy

Implantation of surrogate β-cells, or the more generic term “cell-replacement therapy,” encompasses all methods that involve the creation or expansion of insulin-producing cells in vitro followed by their implantation in the patient. The cells could be of β-cell origin, and perhaps (conditionally) immortalized to allow for unlimited expansion in culture or non–β-cells manipulated producing insulin. Alternatively, they could originate from stem cells, whether adult or embryonal, and have been induced to differentiate into β-cells (or selected to this end) in vitro.

In ReLife, comprehensive medical treatment is done for diabetic patients under special trained team of doctors, who are well qualified and do have great experience. ReLife aims to treat diabetic patients in order to get rid of insulin injections and oral medications, and step forward for a better life.

 

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