Made in City of Hope: A comprehensive approach to curing diabetes

November 27, 2014 | by City of Hope

Diabetes affects nearly every organ in the body. In type 1 diabetes (previously called juvenile onset, or insulin-dependent, diabetes), its cause, and potentially its cure, can be found in the pancreas — home to islet cells which produce insulin, the hormone that enables the body to process sugar.

Fouad Kandeel, M.D., Ph.D. Fouad Kandeel was instrumental in launching City of Hope’s Islet Cell Transplantation Program. He has pursued the safest and most effective methods of transplantation — using islet cells from donors — a far simpler procedure than transplantation of an entire pancreas.

In people with type 1 diabetes — a lifelong condition — the body’s immune system attacks and kills the islet cells. Patients must inject themselves with insulin to control their blood sugar (known as glucose). Transplantation of healthy insulin-producing islet cells is the first step on the path to freedom from this constant struggle.

A leader in the field

Fouad Kandeel, M.D., Ph.D, chair of the Department of Clinical Diabetes, Endocrinology & Metabolism, was instrumental in launching City of Hope’s Islet Cell Transplantation Program. Since leading the first transplantation in 2004, he has pursued the safest and most effective methods of transplantation — using islet cells from donors — a far simpler procedure than transplantation of an entire pancreas.

As Kandeel works to perfect the protocols, or rules, for islet cell transplantation, he’s also working with other researchers and clinicians at City of Hope to create a comprehensive — potentially conclusive — approach to curing diabetes.

This includes:

  • Treatments that encourage the patient’s own immune system to stop killing the insulin-producing islet cells, support their transplantation and eliminating the need for toxic anti-rejection drugs.
  • Other treatments using a growth factor that encourages the insulin-producing islet cells to grow and multiply, thereby reducing the number of islet cells needed for treatment, and possibly eliminating the need for islet transplantation in patients with early-stage disease.
  • New imaging methods to assess the health of transplant’s insulin-producing islet cells in real-time.
It could only happen here

City of Hope has a long and impressive history of groundbreaking discoveries in the field of diabetes, spanning more than four decades. Arthur Riggs, Ph.D., chair of the Department of Diabetes and Metabolic Diseases Research, is widely recognized for his work on the synthesis of the first man-made gene and the use of synthetic genes for the production of human insulin.

Over 10 years ago, City of Hope matched a $1.5 million grant from the Leslie and Susan Gonda (Goldschmied) Foundation to help launch the Islet Cell Transplantation Program, paving the way for an additional $7 million grant from the National Institutes of Health (NIH) a year later.

City of Hope is now a national leader in islet cell transplantation, one of only seven islet cell resource and distribution centers funded by the NIH.

The success of a program such as this one, encompassing so many disciplines and components, requires considerable coordination of resources. City of Hope has established the Diabetes Research Center at City of Hope to serve as an administrative hub to foster and support all diabetes-related activities.

The Center for Biomedicine & Genetics provided Kandeel and his team with both the regulatory expertise and manufacturing skills needed to obtain the islet cells for clinical trials.

Moving forward

Islet cell transplantation is limited by a severe shortage of available donor cells. Work is underway to promote the transformation of stem cells into pancreatic insulin-producing cells. If successful, this would provide a nearly unlimited source of cells for transplantation, making islet cell transplantation a potential cure for all types of diabetes.

New clinical trials are expected to begin accepting patients in late 2014 or early 2015.

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Read more articles from City of Hope's annual report.

 

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