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Spleen Cells Fail to Treat Diabetes

But Insulin-Making Islet Cells Can Recover in Type 1 Diabetes

No Cure, but a Big Step Forward

Apparently, a few islet cells (or precursor cells that can become islet cells) survive the immune attack. When the immune attack is put on pause, the cells grow and start making insulin.

"The positive thing is that, yes, the destructive immunologic process can be controlled," Unanue says. "Even when you have a fully diabetic mouse, there is still a window of time in which you can rescue [islet]-cell function."

How does Faustman feel about having a major part of her findings refuted? She's delighted.

"We are elated by these three stories coming out," Faustman tells WebMD. "These papers now show that others, too, can cure these end-stage diabetic animals. And they show the cure is sometimes totally driven by regeneration of islets in the pancreas. All three show they can do it independent of live, introduced stem cells. It is extremely good news."

'$64,000 Question'

Unanue says while the destructive immune process of type 1 diabetes can be put on hold, it's still not possible to stop it once and for all. And even if scientists leap that hurdle, it's still probable that this will rescue islet cells in people who've had type 1 diabetes for many years. They likely will need some kind of islet transplant -- or some way to encourage other precursor cells to become insulin-making cells.

That last idea isn't moonshine. For example, a recent study in Switzerland showed that human fat tissue contains cells that can become insulin-making cells.

"The $64,000 question is, if you had diabetes for 10-20 years, can you regenerate beta cells all by yourself, or do you need a boost as well?" Faustman says. "If they need a boost, we will have many cell populations available in the future. But our clinical hope is that getting rid of the disease will become possible simply by getting rid of autoimmunity."

Unanue, too, is optimistic.

"There is indeed significant progress in our understanding of how the immunologic process against [islet] cells can be controlled," he says. "It all should actually result in new ways of looking at the disease or actually formulating future therapies for it. Type 1 diabetes is a very complex chronic disease. There are many components. But the understanding is going so well, we should see new developments before too long."


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