Cell-based therapy promises to transform treatment of Type 1 diabetes

While he won’t call it a cure, Harald Stover acknowledges the cell-based encapsulation therapy he’s developed has the potential to drastically change the lives of the over nine million people around the world living with Type 1 diabetes.

The therapy could potentially eliminate or alleviate the need for insulin injections and the immune suppression drugs these patients currently rely on, says the McMaster University chemistry & chemical biology professor.

Type 1 diabetes is a chronic disease where a person’s pancreas makes little or no insulin, an important hormone that helps to regulate one’s blood sugar levels. Patients must manage their symptoms via regular monitoring, injections of insulin and through diet and lifestyle.

“The current standard of care is you measure six times a day and you inject insulin. And that keeps you alive and largely healthy,” says Stover. “But it’ll still take a number of years off your lifespan and you might have problems with your eyesight, kidneys, heart, toes and fingers.”

Adults with diabetes face a range of health complications, including having a two- to three-fold increased risk of heart attack and stroke, and they are more likely to have poor outcomes for several infectious diseases.

Sicker patients can currently become eligible for transplantation of islet cells from the pancreas of a deceased donor — an area where Stover’s therapy could play a pivotal role.

A diver’s shark cage 

Stover’s therapy would involve encapsulating those donor pancreatic islet cells, which contain insulin-producing beta cells, in a hydrogel that effectively hides them from the recipient’s immune system, but still allows for a transfer of materials.

Currently, transplant recipients must be on immune suppression drugs for the rest of their lives because their body sees these transplanted cells as invaders that must be destroyed.

Stover likens his therapy, which he has been working on over the last 20 years, to a diver’s shark cage — water can pass through, but the human is safe from attack.

“With our approach, we would be able to reduce or remove the need for lifelong systemic immune suppression,” says Stover, who points out immune suppression therapy leaves patients at higher risk for infections and cancer.

Stem cell-derived beta cells

Stover’s technology, which he presented at the World Polymer Congress this summer, also comes at a time when there have been many developments around the lab-based creation of stem cell-derived beta cells. With the promise of an unlimited source of insulin-producing stem cells, patients would no longer have to rely on a much smaller pool of organ donors.

“[These labs] could make enough stem cells to treat thousands of people,” says Stover. “We could work with those large companies and say, ‘let us encapsulate the stem cell-derived beta cells before you implant them.’”

Having a source of stem cells, and Stover’s encapsulation therapy alleviating the need for immune suppression, would mean many more Type 1 diabetics could opt for a transplant and could eventually do away with the near-constant monitoring of their blood sugar levels.

“In principle, at the end of the day, the patient would not need any intervention for years,” says Stover.

 A scientific leap 

Just over 100 years after the discovery of insulin revolutionized the treatment of Type 1 diabetes, Stover says he is excited to see science make another big leap in the treatment of the auto-immune disease.

“It is very exciting to see that fundamental science developed at the university has an opportunity to go out and move towards the clinic and ultimately help patients,” says the polymer chemist.

Stover co-founded Allarta Life Sciences, a Hamilton-based pre-clinical life science company, to help get his therapy to patients faster. He says McMaster’s support was crucial in its development.

“Mac was involved early on and was very supportive of our spinoff company,” says Stover. “I don’t think we would be doing this if Mac had not taken an interest in supporting this.”

And while clinical trials could be several years away, Stover says his technology has been positively received and he has heard from many people living with Type 1 diabetes who are hoping to be involved.

A very personal impact 

Diabetes is on the rise, especially in the world’s middle-income countries.

A 2016 report from the World Health Organization (WHO) estimated the direct annual cost of both Type 1 and Type 2 diabetes around the world is more than US$ 827 billion.

“The World Health Organization called diabetes the largest global health epidemic prior to COVID-19,” says Stover.

Beyond the large economic impact elevating the treatment of Type 1 diabetes could have, Stover points to the very personal impact it would have on the lives of patients and their caregivers.

“Type one diabetes is a huge burden,” says Stover. “And that [patient intervention] could be hugely reduced and without the risk of immune suppression.”

“It’s a big deal.”