Professor Shareen Forbes, at University of Edinburgh, and Dr Lisa White, at University of Nottingham are exploring better and more innovative ways to transplant islets, clusters of pancreas cells, into people with type 1 diabetes to enable them to make their own insulin. This could pave the way for wider use of this life-changing treatment, while also making islet transplants much more effective.

Background to the research project

In an islet transplant, clusters of cells (called islets) from a donor pancreas are transplanted into someone with type 1 diabetes and start to produce insulin. They’re currently offered to some people with type 1 diabetes who have severe hypos and no awareness of them. However, usually about 60% of the donor cells die soon after transplant.

This means lots of donor islets are needed to have an impact on blood sugar levels. But with a limited number of donor pancreases available for islet transplantation, very few people with type 1 diabetes can currently benefit.

What’s more, islet transplants aren’t as effective as they could be. They rarely allow people to produce enough insulin to stop insulin therapy. And people need to take anti-rejection drugs to prevent their bodies rejecting the donor cells, which can bring serious side-effects.

Scientists are looking at ways to improve the benefits and availability of islet transplants, so they can become part of a cure for type 1 diabetes. Professor Forbes and Dr White think drugs packaged inside microparticles could provide an answer. Microparticles are tiny particles that help to protect a drug from the harsh environment in the body and deliver it to exactly where it’s needed. If drugs that keep islets healthy and protect them from the immune system could be transplanted alongside islets, it could help them to survive and thrive for longer.

What will the team do in this project?

Professor Forbes and Dr White will package microparticles with immune-altering and other drugs to improve the survival of transplanted islets. They will test different combinations of drugs in islet transplants in mice, to see which work best to help islets survive and control blood sugar levels.

The team will then run experiments to investigate how to scale up the dose of the drugs and how the treatment might work in humans.

Finally, they will check if the most promising drug microparticle combinations also work to protect beta cells that have been grown in the lab from stem cells.

How will this research help people with type 1 diabetes?

At the moment only a tiny fraction of people living with type 1 diabetes are eligible for islet transplants. And they’re far from a permanent or perfect fix.

If the team can improve the survival of donor islets it could unleash the benefits of islets transplants – making them much more effective at managing blood sugar levels, eliminating the need for anti-rejection drugs and opening them up for more people with type 1 diabetes.

In the longer-term, their discoveries could also be used to radically improve transplants of lab-made beta cells. This would entirely remove the supply problem of using donor cells, so that in the future everyone with type 1 diabetes could benefit from transplants.

Professor Shareen Forbes said:

“I hope the Grand Challenge’s investment will give people living with type 1 diabetes hope that a cure can be achieved in their lifetime.

“The funding has allowed scientists from diverse fields to come together in this project with a common goal of doing some truly innovative research that will advance the field. By improving the benefits of human pancreas cell transplants, and in time transplants using stem cells, we hope to contribute towards a future where people with type 1 diabetes can live a life free from insulin injections.”