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Stem Cell Research

By David Mendosa

Last Update: February 1, 1999

Back in the 19th century, an Italian economist named Vilfredo Pareto observed that 80 percent of Italy's wealth was owned by 20 percent of the population. The split, of course, may not be exactly 80/20, but the principle holds true for many other areas.

Stem cells are…all-purpose cells.

Even for news about stem cell research.

It seems that one of the top five or six of these research centers, the University of Miami's Diabetes Research Institute, gets about 80 percent of the publicity for the work on stem cells. Certainly, its announcement in December was dramatic.

Three months earlier doctors at the institute had transmitted insulin-producing cells called islets and specially enriched bone marrow into a 40-year-old woman named Jackie Demijohn with type 1 diabetes. She was the first person in this country to have that operation without also having to receive an organ transplant at the same time.

Previously, islets were only available to patients who also required a transplanted kidney or liver or other organ necessary to save their lives. For the rest of their lives they have to take anti-rejection drugs to prevent their bodies from rejecting the transplant. However, anti-rejection drugs, which suppress the patient's immune system, pose serious health risks.

At least two things were different for Ms. Demijohn. The institute used a new anti-rejection drug that hopefully can phased out in a year. They also used bone marrow cells from the islet donor that they hope will help her body accept the transplanted islets.

"This newly developed technology enables us to efficiently select out a type of bone marrow cell called CD34+ stem cell," says Rodolfo Alejandro, M.D., professor of medicine at the University of Miami and associate director of the institute's cell transplant center. "That is another way of saying that we're eliminating the more mature T cells from the donor's marrow—the ones we believe may cause a reaction against the host's cells."

As exciting as the institute's work is, it is far from the only research underway. The islet regeneration program at the Strelitz Diabetes Institutes at Eastern Virginia Medical School in Norfolk, Virginia, "is going on gangbusters," says research director Aaron I. Vinik, MD.

Dr. Vinik took time to explain his work on December 3 and December 10 to participants on Melissa's Diabetes Chat. He used a protein his team discovered called islet neogenesis-associated peptide (INGAP). It stimulates stem cells to grow and transform into cells that can make insulin.

The surprising thing is that INGAP, he says, appears to target very specifically the cells in the pancreas and no other site. Even more important is that when it is expressed, it occurs only in regenerating pancreases and no other tissue. "For these reasons we do not expect it to be toxic and do not expect it to have untoward effects on any other tissue."

Some newspaper articles have already hailed INGAP research as being as important as the discovery of insulin. Nevertheless, right now INGAP research is at a basic stage, Dr. Vinik says. Human research hasn't started yet and so far the animal response rate is 30-40 percent.

Other research institutes working in this field include the Whittier Institute for Diabetes in La Jolla, California. It's the diabetes research and patient care arm of ScrippsHealth, a San Diego hospital group.

"Our laboratory is using human fetal pancreatic cells in efforts to develop a cell line which is glucose-responsive," says Director Alberto Hayek, M.D. "We have found that cells from human fetal pancreatic tissue, when transplanted into diabetic mice...give rise to insulin-producing cells, which reverse the diabetic state."

It happens that another organization headquartered in La Jolla, California, The Scripps Research Institute, has licensed its technology to identify and isolate pancreatic stem/progenitor cells. CytoTherapeutics Inc. of Lincoln, Rhode Island, says that its exclusive license will let it patent these stem cells to treat diabetes.

And other companies too are working to do well for themselves by doing good for people with diabetes. One of these is Ixion Biotechnology Inc. of Alachua, Florida.

Its key technology is based on islet progenitor stem cells (IPSC). Its Web site says that "IPSC technology allows the growth of substantial numbers of islets from stem cells derived from adult donors and can lead to a supply of islets for transplantation therapy, novel growth factors, or both, to treat diabetes."

Because stem cells are primordial all-purpose cells from which all tissues of the body develop, the scientists and entrepreneurs working with them have high hopes of generating insulin-producing cells. If and when they do, it won't be too much to say that they will have finally found a cure for diabetes. 

The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.

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