Mixed chimerism and growth factors augment β cell regeneration and reverse late-stage type 1 diabetes

Sci Transl Med. 2012 May 9;4(133):133ra59. doi: 10.1126/scitranslmed.3003835.

Abstract

Type 1 diabetes (T1D) results from an autoimmune destruction of insulin-producing β cells. Currently, islet transplantation is the only curative therapy for late-stage T1D, but the beneficial effect is limited in its duration, even under chronic immunosuppression, because of the chronic graft rejection mediated by both auto- and alloimmunity. Clinical islet transplantation is also restricted by a severe shortage of donor islets. Induction of mixed chimerism reverses autoimmunity, eliminates insulitis, and reverses new-onset but not late-stage disease in the nonobese diabetic (NOD) mouse model of T1D. Administration of gastrin and epidermal growth factor (EGF) also reverses new-onset but not late-stage T1D in this animal model. Here, we showed that combination therapy of induced mixed chimerism under a radiation-free nontoxic anti-CD3/CD8 conditioning regimen and administration of gastrin/EGF augments both β cell neogenesis and replication, resulting in reversal of late-stage T1D in NOD mice. If successfully translated into humans, this combination therapy could replace islet transplantation as a long-term curative therapy for T1D.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 1 / therapy*
  • Disease Models, Animal
  • Epidermal Growth Factor / administration & dosage
  • Female
  • Gastrins / administration & dosage
  • Humans
  • Insulin Resistance
  • Insulin-Secreting Cells / pathology
  • Insulin-Secreting Cells / physiology
  • Islets of Langerhans Transplantation*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Inbred NOD
  • Mice, SCID
  • Mice, Transgenic
  • Regeneration
  • Translational Research, Biomedical
  • Transplantation Chimera
  • Transplantation Conditioning

Substances

  • Gastrins
  • Epidermal Growth Factor