How islet cells can survive – and save lives

Clinical study for improved treatment of type 1 diabetes

How islet cells can survive – and save lives

A sub-group of patients with type 1 diabetes have a very severe form of the disease. Fluctuations in blood sugar arise very rapidly and are almost impossible to control. Quality of life is adversely affected and there is a high risk of severe organ damage. Ultimately, this leads to a considerably higher mortality rate for this patient group.

“To give these people better control of their diabetes, it is possible for them to receive transplants of insulin-producing cells, known as the islets of Langerhans or islet cells. These are extracted from the pancreas of a deceased donor”, says Henrik Nittmar of the research company, Corline.

Insulin-producing factories

The islet cells are introduced via a catheter into the fine blood vessels in the recipient’s liver. Once there, they become attached and act as small, insulin-producing factories.

“This method has been shown to work well. The patient gets back part of their insulin-producing capacity and avoids the extreme blood sugar fluctuations. In the long run, it is a life-saving treatment”, says Henrik Nittmar.

Threatening reaction

The problem is that the recipient’s immune system responds with inflammation and coagulation. As much as 70 per cent of the newly transplanted islet cells are eliminated after only one hour.

“This reaction always happens, but to varying degrees, and it means the transplantation must be repeated for the treatment to have an adequate effect. At present, an average of 2.7 donors are required per patient to achieve good results. This is very unsatisfactory in view of the prevailing acute shortage of organs”, states Henrik Nittmar.

Protecting coating

Corline’s solution to the problem is to modify the cells with Cytoparin, which means that the islet cells are pre-treated with a protective coating of large heparin molecules. Heparin, a well-known substance used to reduce coagulation, also has an anti-inflammatory effect.

“It’s a simple three-stage process that uses standard equipment”, comments Henrik Nittmar.

All set for clinical trials

Cytoparin was approved last year for clinical trials by the Swedish Medical Products Agency and in addition to cooperation partners Uppsala University Hospital, Karolinska University Hospital in Huddinge and Oslo University Hospital, Corline is now also collaborating with clinics in Oxford, England and Edmonton, Canada.

“The principal advantage is that we create a more body-friendly transplant. The company estimates the market has an annual worth of SEK 400 million and I expect to have achieved a market introduction within three to five years.”

Updated: 7 December 2017

Text: Jörgen Olsson