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Advancing cell replacement therapies to treat more people with type 1 diabetes

May 5, 2020

Islet transplantation is offered at selected, specialized hospitals as a treatment option for patients with difficult-to-control type 1 diabetes (T1D). The procedure involves isolating islet cells from one or more donor pancreases and transplanting them into the liver of a person with severe T1D. This therapy has been ground-breaking in recent years, and up to 50% of recipients are reportedly free from insulin injections up to five years post-transplant. Unfortunately, factors such as the scarcity of healthy human donor pancreases and the requirement of lifelong anti-rejection drugs pose great challenges to islet graft survival and patient quality of life. However, a new research project headed by Dr. Andrew Pepper – the recipient of JDRF’s 2019 Career Development Award – may help overcome some of the barriers that prevent islet replacement from becoming a readily available treatment for T1D. 

Dr. Pepper is a promising young Canadian scientist and a new assistant professor in the Department of Surgery at the University of Alberta. Along with his team, he is examining the underlying mechanisms that govern pancreatic beta cell survival and function, with the ultimate goal of developing islet replacement therapies that could become a universal treatment for a broader range of people living with T1D. This will be achieved through continued innovations in novel strategies to preserve beta cell mass, enhancing transplant therapies outside the liver and using stem cell-based insulin-producing cell sources.

“With the critical support of JDRF, my laboratory will strive to preserve the legacy of the Edmonton Protocol while ushering in a new era of cellular transplantation,” says Dr. Pepper.

“With the critical support of JDRF, my laboratory will strive to preserve the legacy of the Edmonton Protocol while ushering in a new era of cellular transplantation,” says Dr. Pepper.

“By reducing and potentially eliminating the need for life-long systemic immunosuppression, we hope to broaden the spectrum of T1D patients that can benefit from this life-alternating cellular therapy.”

Dr. Pepper was a JDRF postdoctoral fellow in the lab of Dr. James Shapiro, who pioneered the Edmonton Protocol for islet transplantation, first reported in 2000. If successful, Dr. Pepper’s research could lead to further exciting contributions in the field of beta cell replacement such as improved efficiency of islet engraftment and the development of minimal immunosuppressive and tolerance approaches for implantation. At the same time, his work could foster a better understanding of islet death early in the course of T1D and contribute to approaches that aim to stop disease progression in recent onset disease. 

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