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Who Needs B-Cells, Say the K-Cells
A Canadian company called EnGene Inc. claims to have developed an innovative genetic approach to potentially overcoming diabetes. I’m using the term “overcoming” because what EnGene is working on is not a cure per se, but a pretty cool workaround.
Here’s the deal:
As you all know, insulin is produced in the human body by beta cells in the pancreas. In the case of Type 1 diabetes, the immune system’s T-cells destroy the beta cells and therefore the body no longer has the ability to produce insulin. Type 2s either can’t produce enough insulin or tissues in the body are unable to use insulin properly.
Researchers at Vancouver-based EnGene Inc. have come up with an interesting idea, which they call “mimicking natural insulin delivery.”
The human intestines contain billions of so-called K-cells, and according to EnGene’s web site:
These cells normally respond to sugar levels in the digestive tract after a meal by secreting GIP (glucose-dependent insulinotropic polypeptide) into the bloodstream in a pattern that parallels the secretion of insulin. GIP acts as an “early warning signal,” alerting the pancreas to the presence of food and the pending need to release insulin to enable glucose absorption.
In other words, the K-cells work somewhat similarly to the beta cells and complement their work. EnGene’s basic idea is to genetically alter K-cells so that they can take over the beta cells’ function of producing and delivering insulin. For more in-depth info on how this is done, there’s a great article in ScienceNews, based on an EnGene presentation at a biotech event in San Diego in June.
EnGene says they have successfully tested this in mice by comparing three groups: healthy mice with normal insulin production; mice whose beta cells had been destroyed; and mice whose beta cells were destroyed, but whose K-cells had been genetically altered to produce insulin.
Check this out:
All three groups were given oral glucose. As you can see, the diabetic mice (green line) start out immediately with elevated blood sugar, while the mice with engineered K-cells (yellow line) react like normal animals (white line).
“The treated mice producing insulin from their K-cells continued to be healthy for several months. The untreated diabetic mice survived no more than a week without insulin injections,” the company states.
(Yep, thanks for reminding us …)
What’s next, you wonder? They’re not ready for human trials just yet, but are moving on to testing in pigs, whose intestines are very similar to human intestines. The company hopes it will be able to begin human studies by 2010.
Of course, I’m not planning to throw out my insulin pump by that date. There are any number of promising new approaches that so far only work on mice. And even if they’re successful, it will take many years before the new treatments obtain FDA approval and become commercially available.
And in the case of EnGene, there’s more: since the human body constantly replaces K-cells, PWDs would have to receive a new dose of insulin-producing K-cells roughly every five months. Here’s the catch: EnGene currently sprays the K-cells directly into the gut lining using a modified endoscope (!), which I will NOT be subjecting myself to two or three times a year. According to the above-mentioned ScienceNews article, the company says it might also be possible for patients to ingest the K-cells in a drink or a pill. Now we’re talking.
So why am I writing about EnGene now? First, it’s exciting because it makes us hopeful for the future. I frequently hear from frustrated PWDs who are giving up hope that this disease one day will be cured. Some folks subscribe to the conspiracy theory that big pharma is thwarting the development of cures to protect their massive revenue streams from diabetes. I think there’s plenty of evidence that pharma and biotech are working hard to improve treatment and to find a cure. And let’s not forget this: whether EnGene or somebody else, whoever comes to market with a break-through therapy first (i.e. cure) will be rolling in dough.
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One concern I’m not hearing addressed is the autoimmune component of autoimmune diabetes… isn’t there a high probability that the same path that kills the beta cells will destroy the k cells and/or the insulin they produce?
Posted by: tmana | July 10th, 2008 at 7:13 amColonic irrigation or hydrotherapy is very popular in Hollywood these days! While this is interesting, there is some scientific evidence which suggests potential problems, too. The first, as tmana aptly noted, is the issue of ongoing autoimmunity … something that INGAP and beta cell regeneration treatments are now exploring how best to address in type 1s. The other is the suitability of the location … we know that with islet transplantation, the host site in the liver is believed to be one reason that sustained insulin independence is seldom observed — there’s a very good reason the beta cells have a home in the Islets of Langerhans! Then there is the little issue of diabetes complications like gastroparesis as well as autoimmune-mediated celiac disease which could adversely impact the idea of K cell therapies. While these ideas are hopeful, take it from those of us who have many more decades of hearing how close a cure is … don’t hold your breath waiting!
Posted by: Scott | July 10th, 2008 at 8:04 amworking hard to improve treatment yes trying to find a cure not so much it comes down to simple economics.. and just a bit of a sort of trivia question what was the last disease ever cured and what year or decade?
Posted by: jeremiah | July 10th, 2008 at 9:03 amLast I remeber is wiping out polio with a vaccine, not a cure, and even that wasn’t completely successful. Nope, don’t hold your breath for a cure, they’ve been saying the cure is right around the corner since 1923.
Posted by: Melissa | July 10th, 2008 at 9:43 amthats also around the same time polio got its vaccine makes you wonder why no progress has been made since then??
Posted by: jeremiah | July 10th, 2008 at 10:08 amRegarding tmana’s comment, I think even though K-cells and beta cells are both insulin-producing they probably are physically different. My biology is fuzzy, but I believe the antibody grabs on to specific folds on a protein. K-cells might be different enough to escape.
Anybody catch the article about a gastric surgery reducing Type 2?
(http://www.sciencedaily.com/releases/2008/03/080305113659.htm
Basically, if they perform a bypass around the upper small intestine Type 2 diabetes goes into remission. I know the two diseases are totally different, but when considered next to the K-cell therapy, it sounds like the GI tract may play a bigger role in glucose regulation than anyone realized — these guys may be on to something.
Posted by: Beth | July 10th, 2008 at 2:28 pmRegarding diseases that have been cured or can be treated:
- 60 years ago virtually any bacterial disease or infection could have killed you, then they discovered antibiotics (incl. typhus, cholera, syphilis, leprocy, meningitis, encephalitis …..) as well vaccines
- 50 years ago you would probably have died from minor heart disease (including kids born with congenital heart defects, so called blue babies), then in the 50s and 60s they discovered heart-lung machines and how to operate on living hearts
- All types of major surgery and specially organ transplants were virtually impossible 40-50 years ago, today some are even routine and there are people alive today using artificial hearts
- 20 years ago you probably would have gone blind from glaucoma, today while it cannot be cured progress can be arrested and blindness avoided with over 90% success rate
- 85 years ago you would have died very quickly from Type-1 diabetes, today in Europe life expectancy for people with diabetes diagnised before age 15 is around 10 years less than average (ie around 55 years with diabetes). For people who got T1-D in the 40s and 50s, life expectancy was 20-25 years. Latest statistics that I saw in Germany, amputations from diabetes are down almost 50% in the last 20 years, as well as diabetes related blindness.
- Life expectancy for people with many types of cancer has increased significantly over the past 10-15 years as has life expectancy for people with HIV-Aids (which today is almost “only” a chronic disease - 10-15 years ago it was a death sentence)
So its slow going and frustrating, but hang in there !!!
Posted by: Titos | July 10th, 2008 at 4:22 pmHi Amy,
First of all, Awesome blog.
Posted by: Fernando | July 10th, 2008 at 6:58 pmGreat post.
Isn’t amazing what the human mind is capable of doing?
One thing.
Every day of my diabetic life, I am glad that there are pharmaceutical companies out there rolling in dough. Thanks to them and their profit motive I am still alive. Sometimes we ignore the fact that big pharma only makes profits by saving and improving our lives. I hope big pharma gets even bigger and makes even more money. I wouldn’t like for any medicine lab to be working on the next glucose monitor in some dinky, wet and dirty basement somewhere in a third world country due to a lack of funds, would you? We need to remind ourselves that pharmaceutical companies are in the business of making medicines to treat diseases, they are not in the business of finding cures. I am so thankful they exist and that they are successful.