[HN Gopher] Type 1 diabetes reversed by new cell transplantation...
___________________________________________________________________
Type 1 diabetes reversed by new cell transplantation technique
Author : 01-_-
Score : 474 points
Date : 2025-02-24 15:24 UTC (4 days ago)
(HTM) web link (newatlas.com)
(TXT) w3m dump (newatlas.com)
| Trasmatta wrote:
| > To prevent islet rejection, immune-suppressing drugs are given
| over the long term.
|
| This makes it a non starter. Immunosuppressants are generally
| considered a worse quality of life than insulin treatment. That's
| why pancreas transplants are generally only done for type 1
| diabetics if they are already on immunosuppressants.
| Terr_ wrote:
| I'm hopeful that someday we'll have a good system for "caging"
| cells to prevent an immune response (in either direction) while
| also permitting the visitors to sustain themselves with blood
| nutrients and regulate hormones or clean waste.
|
| Sort of like the role of the blood-brain barrier, or maybe a
| placenta.
| Trasmatta wrote:
| Yes! I think there was some work being done with a islet
| transplant like that. I'm not sure of the details though -
| it's probably a long way off, if it works.
| Gibbon1 wrote:
| What'd be interesting would being able to shut down specific
| auto-immune responses. Currently most of what we have are
| hammers of one sort or another.
| Terr_ wrote:
| I am of the glum opinion that the hideously interwoven
| nature of our immune system is at least partly a security
| feature rather than an engineering flaw.
|
| That said, we might still learn from the success of its
| contemporary attackers, who haven't been slacking over the
| past millions of years either.
| pixl97 wrote:
| Yep. The hard, if not kear impossible part will be just
| resetting the one part of the immune system attacking the
| islets without turning off or resetting the immune system.
| mlhpdx wrote:
| The promising part here is that someday it will be possible
| to take stem cells from a patient and specialize them to
| islet cells. Similar to what they're doing here with vascular
| cells. It's far too expensive at the moment, but ultimately
| the process will be improved and refined, and the costs will
| come down. At least that's my hope for a cure.
| im3w1l wrote:
| Easiest method may be to nuke the immune system and put a new
| one in place. As the immune system consists of several parts
| it may be sufficient to just replace one of them.
| jajko wrote:
| Sounds like 22nd century tech at least. Good to dream of,
| not practical even for very young here to think it would
| help them
| throwawaymaths wrote:
| not really? this is basically already deployed as a cure
| for AIDS (with an N in the single digits iirc). the issue
| is not technical, it's that it's such an extreme solution
| that without more safety data it's ethically a hard sell
| for a condition like diabetes.
| forgotpwagain wrote:
| Lots of biotech companies are working on immunosuppressant-free
| islet-equivalent transplantation.
|
| Two examples off the top of my head: Sana recently announced
| islet cell transplantation without immunosuppression (press
| release: https://ir.sana.com/news-releases/news-release-
| details/sana-... ) and Vertex (ongoing trial:
| https://www.breakthrought1d.org/news-and-updates/vertex-laun...
| ).
| markdog12 wrote:
| Note this is for the current common approach, not the new
| approach.
| bradleyy wrote:
| As a T1D: can confirm. Taking insulin is a hassle, but
| definitely not "I'd rather take immunosuppressants". I'm having
| a hard time even contextualizing how much worse that is.
| WindyMiller wrote:
| ...IN MICE
| mlhpdx wrote:
| And not just mice, but mice engineered with "T1D like"
| conditions. Human testing too early is certainly undesirable
| but these studies with mice, while necessary and important, are
| nothing newsworthy for the general public (but good for
| fundraising for follow up work).
| _carbyau_ wrote:
| Yeah! How amazing is that! Reversing type 1 diabetes anywhere
| is amazing.
|
| A way to go until it becomes an option for humans. And then way
| more to go until it becomes a preferred option.
|
| But this is great news.
| jfengel wrote:
| Not if it requires immune suppressants. They can already
| transplant whole pancreases. They rarely do because the
| resulting lifetime of immune suppression is worse than the
| quite effective insulin injections.
|
| Any research could pay big benefits eventually but this is
| far from "great news". It's a step forward along a path that
| is actually well behind the others.
| _carbyau_ wrote:
| I think you and I have a different approach to science.
|
| I see research as not entirely linear and think that
| multiple paths should be funded. Most paths won't be "the
| definitive answer" but add capability, or definitively rule
| out an approach, that can be used in other scenarios.
| TheFineArticle shows a _different_ path to the others and
| they made a great step on it - that seems like money well
| spent to me.
|
| What I get from reading your post is that it's some kind of
| race and only the one currently winning should be lauded.
| I'm not sure if that is what you intend to communicate
| though.
| energy123 wrote:
| Rapamycin increases lifespan of mice more than any other
| known compound.
| nahsra wrote:
| Longevity benefits are seen at a much lower dose.
|
| https://en.m.wikipedia.org/wiki/The_dose_makes_the_poison
| bitwize wrote:
| Late last year a woman's T1D was put into remission using beta
| cells derived from her own stem cells:
| https://www.nature.com/articles/s41591-024-03394-9
|
| She was on immunosuppressants, so how long the new beta cells
| would last without those is still an open question. Other
| similar, ongoing trials are showing promising results.
| strkitten wrote:
| Indeed, I would appreciate if the title were updated to reflect
| that the subjects were mice, not humans. It's a bit misleading.
| karim79 wrote:
| So it's a trade-off between increased risk of cancer[0] and the
| consequences of type 1 diabetes? Doesn't sound like a fun trade-
| off but I don't know anything.
|
| [0] https://www.cancer.gov/about-cancer/causes-
| prevention/risk/i...
| Trasmatta wrote:
| Type 1 diabetic here: you're right, it's a bad tradeoff. We
| already can do pancreas transplants for T1D, but the reason
| it's very uncommon is that immunosuppressants are a very bad
| tradeoff. Insulin treatment is preferred in the vast majority
| of cases.
|
| Stuff like this will never be a breakthrough until it doesn't
| need immunosuppressants. The best advancements in diabetes
| treatment will most likely continue to be on closed loop
| artificial pancreas systems.
| karim79 wrote:
| I'm sorry for your plight and I genuinely hope there will be
| a much more tenable solution in the near future.
| nextos wrote:
| Insulin-specific immunotherapies are currently under
| development. We will soon be able to restore tolerance to
| insulin, and other pancreatic antigens such as GAD-65,
| without the need for broad immunosupressants. Ideally, this
| should stop b cell destruction and conversion to T1D from
| auto-antibody positive status, as well as facilitate islet
| transplants with minimal side effects for those that are
| already T1D patients.
| riebalas wrote:
| I wouldn't call closed loop systems much of an advancement...
| Sure, it doses insulin automatically based off of CGM data,
| but it's barely any better than just injecting yourself. Cons
| even outweight the pros for some - being constantly attached
| to a device is no fun. And the slugishness of exogenous
| insulin (both: the way it is injected and its time of action)
| diminishes any attempts to achieve precision using CGM data
| and algorithms in controlling diabetes. Not to mention CGM
| data isn't that accurate/rapid enough also. All in all, it's
| just not efficient, calling these systems 'artificial
| pancreas' is more of a marketing gimmick than reality, thus
| why a proper cure is needed.
| gsf_emergency_2 wrote:
| There was a recent "breakthrough" involving the same, except
| with patient's own stem cells, & not just in mice.
|
| https://stemcellres.biomedcentral.com/articles/10.1186/s1328...
|
| That would mitigate the cancer risk, since immunosuppression
| would not be required?
| klipt wrote:
| > patient's own stem cells
|
| > immunosuppression would not be required
|
| I don't think that's how Type I Diabetes works. People get
| Type I Diabetes because their immune system attacked their
| own insulin producing cells in the first place. It's an
| _auto_ immune disease. So if you replenish those cells,
| they'll just get attacked again.
| gsf_emergency_2 wrote:
| Possibly, it is defo important to keep tabs on how these
| patients fare after a few years. before we rush to ship
| this
|
| From above link:
|
| > _A 25-year-old woman with type 1 diabetes became the
| first person to successfully receive a transplant of
| insulin-producing cells derived from her own reprogrammed
| stem cells_
| kakoni wrote:
| There were these studies where t1d patients immune system
| was "restarted" and they became insulin free.
| https://pubmed.ncbi.nlm.nih.gov/17426276/
| arcticbull wrote:
| If you take rapamycin or a rapalog as an anti-rejection drug,
| your risk of cancer is lower - not higher - because it's not
| actually an immune suppressant so much as a drug that prevents
| hyperimmunity. [1] Other immune suppressants work differently
| but it's not a blanket true statement that taking anti-
| rejection drugs will increase your risk of cancer. Depends what
| you take.
|
| You can read the section in [1] titled "Cancer prevention in
| humans."
|
| > Starting from 2004, numerous studies demonstrated that
| rapamycin and everolimus reduced the incidence of various
| cancers in organ transplant patients.
|
| [edit] In fact in addition to its use as an anti-rejection
| medication, rapamycin is used as chemotherapy to treat certain
| forms of cancer.
|
| [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC10103596/
| catlikesshrimp wrote:
| Cancer develops resistance to rapamycin. Cancer always finds
| a way
|
| My point is cancer is worse than DI. At least you can manage
| DI
| arcticbull wrote:
| Do you have any evidence that cancer develops resistance to
| rapamycin? I'd love to read a study. The data I linked
| shows lower incidence of cancer among transplant patients
| taking rapamycin than the _general population._
| catlikesshrimp wrote:
| I apologize for not posting any reference. The topic is
| well known in oncology
|
| https://pubmed.ncbi.nlm.nih.gov/21389767/
|
| Disclaimer: The newer the article, the less reliable it
| is. There were well disguised garbage articles in the
| 2000's, but there are too many now.
| arcticbull wrote:
| Thanks I'm going to give it a read!
|
| Off hand my first thoughts are (a) well it would make
| sense that the non-rapamycin-sensitive cancer cells would
| naturally be selected for - but that doesn't mean that
| your rates of cancer would be higher - and (b) how do you
| square this with the measured lower cancer rates in
| transplant patients on rapamycin?
|
| My take, admittedly more research needed on my part, is
| that the cancer risk of anti rejection drugs is because
| the immune system would normally nuke some of these from
| orbit. However rapamycin works differently and doesn't
| suppress the immune system so even with resistance
| developing the cancer risk would still be somewhere
| between lower and neutral.
| hereme888 wrote:
| The author claimed no competing interests, yet his research is
| used for the patents. We'll see how it plays out in the real
| world after all the stardust settles.
| cassidius wrote:
| More groundbreaking research funded by the NIH. It's sad to think
| about how much the US is going to lose with the arbitrary
| slashing and burning and purging.
| asciii wrote:
| Don't worry they'll take credit for saving this
| kleiba wrote:
| Are you referring to the recent Ebola prevention-related
| cuts?
|
| https://www.npr.org/sections/goats-and-
| soda/2025/02/27/g-s1-...
| ck2 wrote:
| The most frustrating thing is they all get away with
| endless daily lies and just move onto the next subject, NIH
| might never recover, certainly not this decade.
|
| https://www.washingtonpost.com/politics/2025/02/26/elon-
| musk...
|
| > _Hours after Musk asserted that USAID had restored its
| Ebola prevention efforts, the agency informed several
| organizations working with the U.S. government to prevent
| the spread of the virus overseas that their contracts had
| been terminated_
|
| > _organizations -- which included UNICEF, which had been
| working with USAID on Ebola prevention in Uganda and other
| countries -- were among thousands of organizations affected
| by the Trump administration's move to cancel foreign-
| assistance contracts_
| istultus wrote:
| The important thing is that these things get funded. It doesn't
| matter what institute funds them. If an institute becomes
| stultified and corrupt, there's no reason to champion it over
| creating another.
| jghn wrote:
| > If an institute becomes stultified and corrupt
|
| Are you implying the NIH is "stultified and corrupt"?
|
| If so, care to back that claim up?
| catlikesshrimp wrote:
| There is no certainty the new order will be better than the
| previous one.
|
| Trying to fix the world with a sledgehammer.
| yapyap wrote:
| What does this comment mean? What institute are you referring
| to in this cryptic comment?
| karaterobot wrote:
| That's true, but I have lots of experience with the NIH, and
| haven't found it stultified nor corrupted. In fact, did you
| hear they recently funded a project that reversed type 1
| diabetes?
| ipv4dhcp wrote:
| Then fund it yourself! Don't try to force me to pay for it.
| jghn wrote:
| I hope that you do not consume a single dime of government
| resources that I'd prefer not to pay for. But I'm going to
| be that's not true.
| anon84873628 wrote:
| Besides what others have said, the government is immune from
| many of the multi-agent coordination problems that trap other
| types of entities. It's basically the essential reason we
| have government at all.
|
| So no, not all things government does can be replaced by the
| private sector, for reasons of game theory.
| arrty88 wrote:
| Most research that is pointed towards important things does get
| funding from NIH. Most research fails. NIH has a bucket of
| money for every major issue facing the population. Just takes a
| few PhD's and a hypothesis to write a proposal.
| sircastor wrote:
| > Most research fails
|
| So long as the research has a conclusion, it's not a failure.
| We learned something. There may be something to be said for
| whether or not the research is a worthy topic, but that's a
| different conversation.
| snailmailstare wrote:
| Without some research the current President would probably
| not be healthy enough to be in office, clearly we have to
| reduce the risk of that happening again.
| ck2 wrote:
| Scientists and their work is not "fungible"
|
| There is going to be AT LEAST a whole generation of loss of
| progress at this point.
|
| Everything is going to slowly crawl to a stop
|
| and it's not an accident but by design, it's right out of
| Project2025
|
| https://www.science.org/content/article/nih-ban-renewing-
| sen...
| klysm wrote:
| Negative results are not a failure - this perception is one
| of the biggest problems with academia
| andreygrehov wrote:
| Slashing is not permanent. It is important to slash in order to
| determine a middle ground. If a company fires 100 employees and
| certain operations stop functioning, they may hire back 10
| employees and reassess. If operations are still not functional
| enough, they will hire 10 more. This process continues until
| everything is operational again. The result is a company that
| functions just as effectively as before but with fewer
| employees. This is an optimization of resources and efficiency.
| philipwhiuk wrote:
| If a government stops functioning, the result isn't the same
| as a company.
|
| The argument that 'slashing' is the only way to reduce
| headcount is also extremely dumb.
| andreygrehov wrote:
| Neither companies nor governments fire 100% of their
| personnel unless a division is no longer needed.
| Governments, especially, have safeguards to ensure
| essential functions continue, so they don't simply stop
| functioning all of a sudden. From a bird's-eye view, a
| government is not much different from a company. They both
| allocate resources, manage personnel and strive for
| efficiency.
| cma wrote:
| Not many safeguards for that under unitary executive
| theory which is likely to become case law soon. Aside
| from impeachment.
| anon84873628 wrote:
| You realize the whole debate is about what different
| people consider "essential", right?
| hn_throwaway_99 wrote:
| How the heck do you apply this process to fundamental
| research? It's pretty much always the case that with basic
| research you could have cut 95% of studies after the fact and
| it wouldn't have made much difference in the end.
|
| The problem is you don't know _which_ 95% of studies
| beforehand.
| turnsout wrote:
| It's historically difficult to advocate for increased budgets
| & spending. Usually what is cut stays cut.
| malfist wrote:
| >It is important to slash in order to determine a middle
| ground
|
| That's not true.
|
| > If a company fires 100 employees and certain operations
| stop functioning, they may hire back 10 employees and
| reassess
|
| How likely is it that 10 employees come back? How likely is
| it that critical institutional knowledge is lost forever?
|
| > The result is a company that functions just as effectively
| as before but with fewer employees
|
| Does it? Have you ever been through a reorg or restructuring
| at work? Do things ever get back to just as effective as
| before any time soon?
|
| > This is an optimization of resources and efficiency
|
| It's squandering human capitol, knowledge and reduced
| efficiency both in the short term and long term. It's the
| most expensive way to reduce your overhead. A far cry from
| optimization.
| andreygrehov wrote:
| > That's not true.
|
| No, that's ^ not true -\\_(tsu)_/-
|
| > How likely is it that 10 employees come back?
|
| Pretty much nobody is irreplaceable.
|
| > How likely is it that critical institutional knowledge is
| lost forever?
|
| In the digital age, almost impossible. Documentation,
| process automation, and knowledge transfer mitigate this
| risk.
|
| > Does it? Have you ever been through a reorg or
| restructuring at work? Do things ever get back to just as
| effective as before any time soon?
|
| Yes, I've been through many re-orgs at AWS. If done right,
| things get better fairly quickly (3-6 months).
|
| > It's squandering human capital, knowledge, and reduced
| efficiency both in the short term and long term. It's the
| most expensive way to reduce your overhead. A far cry from
| optimization.
|
| Not necessarily. The short-term pain of restructuring can
| lead to long-term efficiency gains. Organizations that fail
| to optimize end up bloated and sluggish, which is far more
| costly in the long run. Smart cuts, when combined with
| proper reallocation of resources, create a more effective
| organization.
| malfist wrote:
| > In the digital age, almost impossible. Documentation,
| process automation, and knowledge transfer mitigate this
| risk.
|
| Nobody is so thorough at documenting that their job is
| 100% documented and the documentation is fully up to
| date.
|
| You think Jim, who's been training the new hires on the
| factory floor for a decade, who knows all the tricks to
| making this fit together at wiget factory even when the
| process instructions are vague, has documented
| everything?
|
| Could document everything?
|
| Just be cause digital records are present doesn't mean
| they're complete, up to date or accurate.
|
| Institutional knowledge is a thing, and it's very
| valuable. You can't wave it away and say we're in a
| digital age.
| andreygrehov wrote:
| > You think Jim, who's been training the new hires on the
| factory floor for a decade, who knows all the tricks to
| making this fit together at wiget factory even when the
| process instructions are vague, has documented
| everything?
|
| No, I don't think so. That's why the lay-offs
| predominantly target probationary employees.
| eadler wrote:
| What do you believe "probationary employees" means?
|
| What is their average tenure at the department?
| andreygrehov wrote:
| They are in the first year of employment.
| eadler wrote:
| Is this actually the case? what about people who were
| promoted or moved positions?
|
| Is this the case for all federal jobs or can it be longer
| for some roles?
| jghn wrote:
| No. They are in the first year of their current
| level/role. That may mean the first year of employment.
| It could also mean they were promoted.
| anon84873628 wrote:
| Your last sentence undermines the point in this case.
| What Musk and Trump are doing are hardly "smart cuts".
| They couldn't possibly be, with how quickly executed.
| They are a sledgehammer.
| andreygrehov wrote:
| probationary employees
| costigan wrote:
| It hasn't been limited to probationary employees. Here's
| one example: https://www.science.org/content/article/nih-
| ban-renewing-sen... Agencies have also been directed to
| make plans for "significant reductions". For example, EPA
| plans to cut 65%. Fish and Wildlife and the Bureau of
| Indian Affairs are preparing for up to 40%. These latter
| cuts haven't happened yet, but they're very likely.
| andreygrehov wrote:
| That's correct. It hasn't been limited to probationary
| employees only, but many are. Those who are not either
| aren't needed or will be rehired if operations cannot
| continue without them.
| linkregister wrote:
| recent promotees are probationary
| anon84873628 wrote:
| It's not just about the literal employee contracts.
| Telling all USAID workers to cease operations and come
| home within 30 days is still a "cut" even if they are
| still employed. Not hiring seasonal workers for national
| parks is a cut. Removing info from the CDC website is a
| cut. Cancelling the meeting on flu vaccines is a cut.
|
| It's a very hamfisted deliberate disruption of all
| operations and services. Which, again, can hardly be
| called "targeted" by any metric.
| KumaBear wrote:
| Problem is the funding never gets passed on as a savings to the
| American consumer who needs the treatment.
| thereisnospork wrote:
| The American consumer gets a treatment that didn't exist
| yesterday and whose IP will be free in ~15 years for their
| tax dollars. A pretty reasonable give and take on the face of
| it.
|
| (Not that polices to reduce the cost to Americans, especially
| relative to foreign markets, ought to be unpopular)
| jablongo wrote:
| If you pair this with genetically engineered hypoimmune islet
| cells to avoid needing to suppress immune system you could have a
| viable cure. https://ir.sana.com/news-releases/news-release-
| details/sana-...
| y-curious wrote:
| Yes, immunity is the big problem. You probably need to
| replenish the islets either way. Also, I don't think doctors
| would be content giving someone that isn't suppressed this
| without loads of research.
| gsf_emergency_2 wrote:
| Yes! You can also induce islet cells from the patient's own
| stem cells:
|
| https://stemcellres.biomedcentral.com/articles/10.1186/s1328...
| tech2 wrote:
| Except, a diabetic's immune system already wants to kill
| those too...
| gsf_emergency_2 wrote:
| True, Sana above are attempting to extend their gene
| engineering ("HIP") to stem cells as well
|
| > _apply the HIP technology to develop therapeutic
| candidates at scale, including both pluripotent stem cells
| and donor-derived allogeneic CAR T cells._
| ThrowawayTestr wrote:
| Awesome. Hopefully when this is perfected they'll be enough
| pancreases to cure everyone. My pancreas is ear marked for my
| sibling should I become an eligible donor.
| davidelettieri wrote:
| Also impact of diet should not be underestimated
| https://pmc.ncbi.nlm.nih.gov/articles/PMC5357144/
|
| edit: at least on mices for now
| aktau wrote:
| I've experienced quasi-remission twice now. Both times when I
| got so sick from food in a foreign country that I couldn't eat
| for days (and had no appetite for it either). I lived on water.
| Afterwards, for 1-2 weeks, I did not require insulin (while
| eating a lot).
|
| I used to think it was due to the pills they gave me there, or
| perhaps due to the bacteria (or virus?) causing some strange
| temporal abating of auto-immune response and regrowth of beta-
| cells. But seeing this is making me reconsider that (I was
| doubting the effect of the medicine since I took some home and
| took it in a healthy state but did not get the good effects).
| dsaavy wrote:
| I've been Type 1 for 20+ years and have measurable remissions
| based on blood tests. Low level functioning of pancreas
| again.
|
| The thing that moved the needle for me was fasting + ultra
| running (which from my understanding implements a fasting-
| like response by the body in some ways).
|
| Interesting that not eating for a while correlated with what
| seems like increased pancreatic activity...
| davidelettieri wrote:
| If you are interested, Valter Longo in a fairly recent and
| interesting podcast
| https://youtu.be/ZwdhdevxlRg?si=sDknOzmwx7Nk_wQR
| doubtfuluser wrote:
| in mice
| whostolemyhat wrote:
| 5 years away?
| pepsi-not-coke wrote:
| great, now let's cure type 2, which gets much less attention
| riebalas wrote:
| I have great news for you: you can cure it on your own, just
| get off donuts and move your ass. I'm actually jealous of type
| 2's.
| k4rli wrote:
| Finally with this and Ozempic, I can get diabetes and be fat,
| and then restart the process again.
| smm11 wrote:
| Cool! Now fix Type 2, which is managed by reducing sugar intake.
|
| No, wait, just take a pill!
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