The optimal location to treat type 1 diabetes (T1D) might be just under our skin, according to a recent study.
The University of Toronto study involved transplanting healthy pancreatic cells under the skin to produce insulin for blood glucose regulation.
"The skin has the advantage of being readily accessible," said senior researcher Michael Sefton. "It is also presents fewer hazards than other transplantation sites."
In persons with T1D, insulin-making beta cells, located in regions of the pancreas known as pancreatic islets, are damaged. Implanting healthy new cells could restore insulin function, but it's hard to get them in the right place.
"Pancreatic islets are scattered throughout the pancreas in between other pancreatic cells that secrete digestive enzymes," said lead author Alexander Vlahos. "This makes it impractical to try and deliver islets to the pancreas: you would most likely be delivering it to a region of the pancreas that is secreting these enzymes."
Other sites such as the abdominal cavity and liver aren't much better: they are considered "hostile" environments that can damage the new cells, resulting in loss of function.
Vlahos noted that the accessible location of the skin makes islet transplantation a lot more manageable, especially if the patient responds negatively to the donor cells. The space under the skin has a large area so that it can support many islets, which is necessary for this approach.
Vlahos pursued the idea of transplanting pancreatic islets under the skin because the current method of implanting into the liver requires too many donor cells.
In his tests, Vlahos injected healthy pancreatic islets under the skin and found that normal blood sugar levels could be restored within 21 days, provided he created blood vessels at the same time. When the islet transplants were removed, glucose levels returned to diabetic levels.
However, Vlahos believes that these results mark only the beginning of a bigger picture.
The study is published in the journal Proceedings of the National Academy of Sciences.
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