NZ pioneer brings cure for diabetes a step closer

By Martin Johnston

Ground-breaking Auckland medical scientist Bob Elliott has devised a revolutionary treatment to prevent Type 1 diabetes.

The experimental treatment has been used only in mice, but it has produced good results. If these continue, trials on people could start within 10 years.

Type 1 diabetes affects about 11,000 New Zealanders. It usually occurs in childhood and leaves sufferers unable to produce insulin - used by the body to process glucose - and needing regular injections of synthetic insulin.

It is an auto-immune disease, in which antibodies form and then kill insulin-producing cells.

The new approach developed by Professor Elliott and his team at Living Cell Technologies involves injecting cells taken from neonatal piglets and coated with a gel to protect them from the human immune system.

This is similar to Living Cell's technique of injecting coated insulin-producing cells from the pancreases of piglets.

But in the new treatment, the cells secrete protective proteins responsible for the repair and protection of cells.

The cells are from the part of the brain called the choroid plexus. In previous animal trials, Living Cell has shown that they are protective against neurological diseases such as Huntington's disease.

"This is a completely new approach," Professor Elliott said yesterday. "We know that these cells can protect the brain against the whole range of noxious toxic events.

"It occurred to me, 'How about diabetes', because around each [cluster of insulin-producing cells] is a collection of nerve cells ... a bit like a mini-brain. They have the same sort of insulating cells and nerve plexuses that the brain has.

"I knew from other people's work that that's the site where the attack starts on insulin-producing cells, in the nerve tissue.

"I thought, 'Maybe we can protect that and prevent diabetes'. That's the way it's panned out in the mouse."

Work is now being done on perfecting the technique by finding the right dose and the right age at which to administer it.

"The ultimate goal is to detect people likely to get diabetes ... and try this preventive measure which works quite nicely in mice."

Professor Elliott said all children could be tested through a straightforward finger-prick blood test to find those at high risk. They could then be given the treatment.

"I think this is an immensely safe procedure and it's one that's certainly worth pursuing.

"People have been desperate to find some new approach [to Type 1 diabetes]. They have been jumping up and down on the same spot for 10 years and not got anywhere."

Living Cell has applied to the Health Ministry and health authorities in other countries to resume human trials of its insulin-producing pig-cell transplants after a 10-year break.

It says the New Zealand application has some months to go, but the company expects one of its applications will be approved to start early next year.

Professor Elliott halted a pioneering trial using an earlier version of the technology in 1996 because of fears that humans could be infected by pig viruses.

Variations of these animal-to-human cell transplants for diabetes have been performed in Mexico and Russia.

Living Cell wants to run a year-long trial involving eight adult diabetics, injecting into their abdomens more than a billion gel-coated cells from the pancreases of piglets from the company's herd. The trial would be run from Middlemore Hospital.

The application follows trial transplants into animals with diabetes, which produced no adverse effects, a significant reduction in insulin requirements and freedom from insulin dependence in some cases.

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