Chicago Sun Times profiles Kim Carlson

Excerpt from “Diabetes Breakthrough—Transplant offers ‘functional cure’: UIC researchers working to grow cells for procedure in lab” by Jim Ritter for the Chicago Sun Times, Tuesday, Jan 8th, 2008.

Kim Carlson was diagnosed at age 17 with an especially difficult case of
Type 1 diabetes.

Yet she hasn’t needed a single insulin shot for more than two years.

An experimental transplant of cells from the pancreas of a deceased donor
has, in effect, cured her diabetes.

Carlson, 41, of Lisle, underwent the transplant at the University of
Illinois at Chicago. She is among several hundred diabetics who have
undergone such transplants.

But the treatment has two big drawbacks: Recipients must take
immune-suppressing drugs, and there are nowhere near enough donors to
accommodate 3 million Type 1 diabetics in the United States.

Researchers at UIC and 14 other centers are working to solve both problems
in a collaboration they call the Chicago Project.

In Type 1 diabetes, “islet” cells in the pancreas produce little or no
insulin.

In the new transplant, islet cells are removed from a donor pancreas and
injected into the diabetic’s liver. If all goes well, the cells take up
residence in the liver and begin producing insulin.

UIC has done islet cell transplants on 10 diabetics. After 15 months, eight
were off insulin, said transplant surgeon Dr. Jose Oberholzer.

But patients must take immune-suppresing drugs so their bodies don’t reject
the islet cells. In addition to costing about $10,000 per year,
anti-rejection drugs can cause such side effects as mouth sores, high blood
pressure and kidney failure.

Chicago Project researchers are exploring two possible solutions to this
problem. One approach is to trick the immune system into behaving as if the
donated cells were not foreign.

A second approach is to encapsulate donated cells with a seaweed extract
called alginate. Alginate protects cells from immune system attacks, but is
porous enough to allow insulin, oxygen, nutrients, etc., to move in and out.
UIC plans to begin testing this approach on diabetics later this year.

The second big problem is the inadequate supply of donor pancreases. There
were only about 8,000 deceased organ donors in 2006. That number represents
less than 1 percent of Type 1 diabetics.

To increase the supply, Chicago Project researchers are trying to grow islet
cells in the lab. While it’s relatively easy to culture, for example, muscle
or liver cells, it’s extremely difficult to grow islet cells.

“It’s like nature doesn’t want us to do it,” Oberholzer said.

Elsewhere, researchers are studying the possibility of transplanting islet
cells from pigs, said Julia Greenstein of the Juvenile Diabetes Research
Foundation, which is helping to fund the Chicago Project.

Oberholzer is confident researchers will solve both the supply problem and
the rejection problem. If so, transplants could help many more people like
Carlson.

Although patients still would have diabetes, the transplant would amount to
a “functional cure,” Oberholzer said.