Programme of research could be a game-changer for people with Type 1 diabetes and insulin-dependent Type 2 diabetesUniversity of Oxford research into a new and better treatment for diabetes has been boosted by a major grant. The DRIVE (Diabetes Reversing Implants with enhanced Viability and long-term Efficacy) consortium, which involves fourteen partners from seven European countries, has received €8.9 million (£6.37 million) funding from the European Union’s Horizon 2020 - Research and Innovation Framework Programme. The programme will develop natural materials and new surgical devices to enhance the transplant and survival of insulin producing pancreatic islets for the treatment of diabetes.
Diabetes mellitus is a chronic disease characterised by high blood sugar (glucose). If not treated carefully, diabetes causes several debilitating side effects including heart disease, damage to the eyes, kidneys and nerve endings (e.g. hands, feet) and can lead to premature death. According to the international diabetes federation (IDF), 382 million people worldwide have diabetes and in 2013 an estimated 5.1 million deaths were attributable to the disease, representing 8.4% of global adult mortality. Blood glucose is high in diabetes because of the inability of the pancreas to produce sufficient insulin, a hormone that controls blood sugar. Currently the main treatment for diabetes is the daily injection of insulin. In patients where control is poor, transplantation of pancreatic cells (which contain insulin-producing β-cells) is possible. However there are challenges with this therapy including the short supply of donor pancreases, the need to use 3-4 pancreases to get enough β-cells for treatment and poor graft survival and retention at the transplant site.
The DRIVE consortium will address these challenges by developing a completely new system to deliver pancreatic β-cells effectively in a targeted and protected fashion. This will mean that fewer donor pancreases are needed for cell transplantation allowing more patients to get a more effective longer-lasting treatment with less demand on donor pancreases. Additionally, the consortium will investigate the combination of DRIVE’s technology with future stem cell-derived β-cells that will widen the availability of islet transplantation therapy to all insulin-dependent patients.
DRIVE’s β-System consists of a β-Gel, which contains the pancreatic β-cells within a gel that mimics the pancreas; which itself is protected within a capsule called a β-shell. This is delivered using a specialised injection catheter, called β-cath, which offers a much less invasive surgical procedure than is currently used.
The current transplantation technique offers patients natural glucose control for 1-2 years. DRIVE’s β-system aims to provide control for up to 5 years by increasing the longevity of the β-cell transplant. The system offers further advantages through the slow release of immunosuppressant drugs by the β-shell, reducing the patient’s need for long-term anti-rejection medication, which has harmful side effects. The β-shell will also be retrievable, so it can be removed and replenished after the 5-year period. DRIVE’s 5-year work plan will include animal testing, with a view to human testing at the end of the project.
Professor Paul Johnson, Director of the Oxford Islet Transplant Programme and Professor of Paediatric Surgery at the University of Oxford, said: 'Over the past 10 years, the transplantation of insulin-producing pancreatic cells known as islet cells (that can sense blood sugar levels and release insulin to maintain normal sugar levels) has achieved very promising results in adults who have developed the severest complications from insulin-dependent diabetes. The challenge is to now make sure that more people can benefit from this minimally-invasive treatment.
'Ultimately we would hope that it can be used to reverse diabetes in children soon after diagnosis. The DRIVE Consortium brings together some of the leading researchers in Europe in the fields of bioengineering, cell biology, and cell transplantation. Regenerative medicine and stem cell therapies have the potential to revolutionise the treatment of patients who have diabetes, and through DRIVE we will develop new technologies to enhance stem cell therapies for these patients by increasing targeting and ease of delivery using advanced biomaterials.
'The overall aim is to develop novel membranes to protect the transplanted islets from rejection ensure that islet transplantation can be undertaken without the need for the patient to take anti-rejection medication, with all the associated complications. This programme of research could be a real game-changer for people with Type 1 diabetes and the team in Oxford are very excited to be part of this state of the art research collaboration.'
The DRIVE Consortium represents a major interdisciplinary effort between stem cell biologists, experts in advanced drug delivery, research scientists, clinicians and research-active companies working together to develop novel therapeutics to address the challenges of treating diabetes. The researchers will optimise adult stem cell therapy using smart biomaterials and advanced drug delivery, and couple these therapeutics with minimally-invasive surgical devices.