

Boston-area scientists have overcome some of the major hurdles standing in the way of a long-sought therapeutic fix for patients with Type 1 diabetes. In two studies published this week, they outlined an approach that the body’s immune system could tolerate and provided a possible pathway toward clinical trials in the next few years.
In people with Type 1 diabetes, formerly known as juvenile-onset diabetes, the immune system dismantles the pancreatic cells that normally produce insulin. So researchers have long sought a way to put back healthy insulin-producing cells, known as beta cells, into patients.
“We’re trying to figure out a way to replace nature’s solution,’’ said Douglas Melton, codirector of the Harvard Stem Cell Institute.
For years, physicians have been using beta cells from dead donors. But because the immune system of the recipient recognizes the donor cells as foreign, patients who receive a transplant have to take immune-suppressing drugs for the rest of their lives.
Those drugs are not ideal, because they carry a risk of infection or cancer. Plus, donors are in short supply and can’t yield enough cells to treat the millions of people with Type 1 diabetes around the world.
The researchers behind two studies published Monday demonstrated that they had made progress on both fronts, encapsulating the cells in a protective bubble to shield them from the body’s immune response and creating beta cells from stem cells, which are potentially limitless.
For the capsules, the scientists homed in on alginate — a seaweed extract — as the starting material. Alginate allows sugar and insulin to flow between the cells and the body, but blocks immune cells from reaching the beta cells.
The problem with existing alginates is that the body eventually catches on to the material as a foreign substance, suffocating the implant in a layer of scar tissue. So, Daniel Anderson, a bioengineer at the Massachusetts Institute of Technology, went in search of a better kind of alginate.
In one of two related studies, Anderson and his colleagues described in the journal Nature Biotechnology how they had tested 774 variations of alginate in rodents and monkeys and identified a handful that elicited a greatly reduced foreign body response.
For the other paper, published in Nature Medicine, the group embedded tiny capsules made from that durable alginate with beta cells derived from human embryonic stem cells. They then transplanted them into mice with a disease akin to Type 1 diabetes.
The beta cells performed “every bit as good as the body’s own cells,’’ said Melton, a coauthor on the Nature Medicine paper.
The transplanted cells controlled glucose levels in the mice without immune-suppressing drugs, the researchers reported. And when the scientists removed the capsules after almost six months, the cells were still cranking out insulin, and there was little sign of an immune response to the capsules.
“From very early on, we were getting great success,’’ said Arturo Vegas, a lead author of the papers who worked in Anderson’s lab before moving to Boston University, where he is an assistant chemistry professor.
“Everything kind of fell into place,’’ Vegas continued. “You saw less foreign body response. The human beta cells survived exquisitely well.’’
The studies show “you can take stem cells and make a limitless supply of [human beta cells] and put them in a device and cure an entirely different species of animal,’’ Anderson said.
Just because the system produced strong results in mice does not mean people will respond the same way. But experts say the findings provide hope for future treatments for people.
“This is really the first demonstration of the ability of these novel materials in combination with a stem cell- derived beta cell to reverse diabetes in an animal model,’’ said Julia Greenstein, vice president of discovery research at JDRF, an organization trying to end Type 1 diabetes that provided some funding for the studies.
The potential of the approach has attracted interest from both small startups and large biopharmaceutical companies that are looking at stem cell-based therapies for diabetes.
One company, ViaCyte Inc., launched the first cell replacement clinical trial in 2014. The San Diego company is implanting cells under the skin of diabetic patients through a much larger holding device than the tiny capsules used by the Boston team.
The ViaCyte therapy also relies on less mature cells that, once implanted, differentiate into both insulin-producing beta cells and those that secrete another hormone, called glucagon, that’s deficient in the disease.
“The main issue with Type 1 diabetes is a loss of beta cells,’’ said ViaCyte CEO Paul Laikind, “but there’s also good data out there to suggest dysfunction in other regulatory cell types.’’
Melton also recently helped start Semma Therapeutics Inc. in Cambridge’s Kendall Square neighborhood. Semma has not begun any human clinical trials but the goal is to develop a therapy that could control someone’s blood sugar for a year or more, saving them from insulin injections and the need to check their blood sugar every few hours.
“The individuals would not have to worry about that,’’ said Semma CEO Robert Millman.
Meanwhile, the Boston researchers are validating their therapy in monkey models of diabetes. If the studies succeed, the next step would be developing a therapy for people.
“I think we’ve advanced the ball pretty far, almost as far you could get in an academic environment,’’ Vegas said. “The talk is shifting toward doing something clinically.’’
Andrew Joseph can be reached at andrew.joseph@statnews.com. Follow Stat on Twitter @statnews.