World First Autologous Regenerated Islet Transplantation Successful

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World First Autologous Regenerated Islet Transplantation Successful: 25-Year Diabetes History Patient Cured

World First Autologous Regenerated Islet Transplantation Successful: 25-Year Diabetes History Patient Cured

The world’s first successful autologous regenerated islet transplantation has cured diabetes, with the patient now completely free from insulin for 33 months.

On April 30th, researchers from Shanghai Changzheng Hospital published their research results online in the international academic journal Cell Discovery under the title “Treating a type 2 diabetic patient with impaired pancreatic islet function by personalized endoderm stem cell-derived islet tissue.“

World First Autologous Regenerated Islet Transplantation Successful: 25-Year Diabetes History Patient Cured

This is the first reported case internationally of successfully treating severe pancreatic islet function-damaged diabetes using stem cell-derived autologous regenerated islet transplantation.

Diabetes poses a serious threat to human health. Poor long-term blood sugar control in patients can lead to serious complications such as blindness, kidney failure, cardiovascular accidents, amputations, and even death from ketoacidosis or unconscious hypoglycemia. China is the world’s largest diabetic country with as many as 140 million patients, of which approximately 40 million require lifelong insulin injections. For severely uncontrolled patients, only transplantation therapy, involving the extraction and minimally invasive injection of islet tissue from donated pancreas, can effectively treat the disease and prevent complications. However, due to severe shortages of donors and the complexity of islet isolation technology, it is currently difficult to meet clinical demand. Therefore, developing a method to mass-produce human pancreatic islet tissue in vitro has become a worldwide academic challenge and has attracted widespread attention.

Professor Yin Hao, director of the Organ Transplantation Center at Shanghai Changzheng Hospital, stated that after more than ten years of research, the research team used patient blood peripheral blood mononuclear cells (PBMCs) to reprogram them into autologous induced pluripotent stem cells (iPSCs). They then used an internationally pioneering technology to transform them into “seed cells,” namely, endoderm stem cells (EnSCs), and ultimately achieved the in vitro reconstruction of pancreatic islet tissue (E-islets). This technology has matured and represents a major breakthrough in regenerative medicine for the treatment of diabetes.

The first beneficiary of this technology was a 59-year-old male with a 25-year history of type 2 diabetes and end-stage diabetic nephropathy (uremia). In June 2017, he developed end-stage diabetic nephropathy and underwent a kidney transplant. However, due to his near-failing pancreatic islet function, he required multiple daily insulin injections and faced a high risk of serious diabetes-related complications in the future.

On July 19, 2021, due to concerns about hypoglycemia and the adverse effects of poor blood sugar control on the long-term survival of the donor kidney, the patient underwent autologous regenerated islet transplantation therapy at Shanghai Changzheng Hospital. Starting from the 11th week after surgery, he completely discontinued exogenous insulin, gradually reduced his oral hypoglycemic drugs (pioglitazone and metformin) after surgery, and completely discontinued them at the 48th and 56th weeks. Currently, the patient has been completely free from insulin for 33 months.

Yin Hao stated that since then, the patient’s key indicators such as fasting and postprandial C-peptide have significantly improved compared to before the surgery, confirming the effective restoration of pancreatic islet function. Follow-up indicators such as kidney function are within the normal range, indicating that this therapy can prevent the progression of diabetes-related complications. Overall, this is the first use of autologous-derived islets for the treatment of pancreatic islet function-damaged T2D patients, representing a significant advancement in tissue replacement therapy.

Changzheng Hospital revealed that in addition to the first severe case of type 2 diabetes, the above-mentioned collaborative team has also successfully carried out and cured multiple cases of brittle type 1 diabetes. Yin Hao stated that in the future, the team will focus on research related to stem cell-derived regenerated pancreatic islet tissue, further developing an “off-the-shelf” regenerated pancreatic islet tissue that does not require immunosuppression, thus providing a new cure for the vast number of diabetes patients who rely on insulin injections for life.