Top 10 Takeaways From Harvard Stem Cell Diabetes Paper

Harvard stem cells DiabetesThe idea of using stem cells to treat Type I Diabetes is very promising and could have huge practical impact. Real progress has been achieved toward this goal over the last decade. In perhaps another decade there might be a validated treatment.

A new stem cell paper has just come out in Cell from Harvard in this area. It reports making insulin-producing β cells from human embryonic stem cells (hESC) with the notion of some day using these cells to treat Diabetes. See graphical abstract at left from the paper. These β cells help Diabetic mice control their blood sugar. Very cool.

This is an important, exciting paper, but one that the media has for the most part totally hyped. For a balanced, well-researched newspaper article on this Harvard Diabetes research I recommend this piece by John Lauerman at Bloomberg. It’s also worth noting that the same Harvard team published another big Cell paper related to stem cells and Diabetes last year on a hormone they discovered called Betatrophin that stimulates cells to turn into β cells.

Here are my top 10 key take home messages for this new paper in the context of the larger field of stem cell-related Diabetes research.

  • There are many labs around the world working on research toward the goal of using stem cells as a basis to treat Diabetes. The Harvard work is notable, but should be discussed in this larger context.
  • For example, another entity, the privately held stem cell biotech ViaCyte, has an approved IND for an hESC-based Diabetes treatment and an approved device in the form of a capsule.
  • Harvard will also need some kind of capsulation technology/device, which it does not appear to have at present. Harvard team leader Doug Melton described such a needed device as a “tea bag” with the idea being that the cells inside sense blood sugar (which goes into the capsule from blood) and make insulin (which goes out into the blood), but no cells should be able to go in or out.
  • ViaCyte will start a clinical trial in as soon as a few months for their hESC-based Diabetes therapy.
  • Barring some major change in regulatory approach by the FDA, the Harvard stem cell Diabetes product probably won’t start to be tested in humans for at least about 4 years given the experiences of other groups using human embryonic stem cell-based products. It’s important to keep expectations realistic.
  • Going back to 2006 we find a Nature Biotechnology paper using hESC to make pancreatic progenitor cells that can turn into β cells and other kinds of pancreatic cells, work from a team led by Ed Baetge of Novocell (now ViaCyte). Only now is ViaCyte going to start their in-human trials. These things take time.
  • ViaCyte’s product is not pure β cells, while the Harvard product appears to be relatively pure β cells. This could prove to be an important advantage over ViaCyte’s approach in the long run.
  • A challenge for any stem cell-based product is potential immune rejection by the patient given that Type I Diabetes has an immune component as a disease and the fact that the product will be allogeneic.
  • What works in mice often doesn’t work in humans so caution is in order.
  • Whether talking about Harvard or ViaCyte or anyone else, it is way premature for the media to talk about “cures” for Diabetes. The most appropriate word to use is “treatment”.

 

11 thoughts on “Top 10 Takeaways From Harvard Stem Cell Diabetes Paper


  1. I agree with all the above, and I add one more thing – the economic burden of such a “cure” is at the moment non-viable. If you look closely at the cocktail of reagents/factors/chemicals that are needed to drive hESCs into beta cells in these large-scale cultures, you will notice that they add up to thousands of dollars, in order to treat just one patient… There is a long long way to go before this treatment appeals to the masses.


  2. “Thousands of dollars”? You clearly don’t know how expensive T1D is to treat currently. Last year we spent nearly $20k just to treat my son’s Type 1 (thankfully most was covered by insurance). And that says nothing of his loss of freedom, constant stress, and climbing A1C levels. Spending thousands for a durable and precise treatment would be the bargain of a lifetime.


    • This is an excellent point. The cost of today’s treatments of Diabetes is sky high both for families and collectively. I believe it costs the US alone hundreds of billions of dollars.


  3. Agreed, over 26 years with T1DM I have no idea how much money I’ve spent for supplies, medications, procedures, lab testing, appointments, surgeries. And not to mention the emotional cost. Hands down I would gladly spend thousands upon thousands of dollars to not have this disease. T1DM is only going to cost more as we age too, exponetially, this disease gets more expensive as we age.


  4. Nice that you mentioned the betatrophin story. However, note that the results are bordering irreproducibility: http://www.cell.com/cell/abstract/S0092-8674%2814%2901176-3

    Stem cells are hyped. They might one day be useful. But up to that point, it’s all basic research.

    When I was a medical student doing a neurology round in 1999, the fellow neurologist and specialist in movement disorders discussed with us students the vast advencements in understanding the molecular pathology of many neurogenetic diseases like Huntingtons and different SCAs. He was convinced that effective treatment for a lot of neurologic diseases would be around the corner. We are now 15 years down the road. At the time, I did not think of going into clinical genetics, but it happend. What has not happened to date is treatment. Not a single useful breakthrough treatment for any neurogenetic disease.

    The current state of stem cell research does not make me believe we are anywhere near a breakthrough treatment. Anyone giving any other impression is mainly doing marketing.

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