People with Diabetes Consider Xenotransplantation (barf alert)

Scoop Independent News ^ | May 7, 2005 | New Zealand Bioethis Council

[Investment Biker]

If xenotransplantation - animal-to-human transplantation - were to offer a person with Type one diabetes a life without insulin dependency - would that make it OK?

This is a proposition people with diabetes are being encouraged to consider by Toi te Taiao: the Bioethics Council and Martin Wilkinson, chair of the Council's xenotransplantation working group, who is a key-note speaker at this weekend's annual Diabetes New Zealand Conference.

"People with Diabetes will understand, perhaps better than anyone, the pros and cons of xenotransplantation because it has the potential to affect them personally. There are in fact several xenotransplantation procedures but one involves the insertion of cells, like pig pancreatic islet cells, into humans. This has the potential to treat Type one and severe Type two diabetes.

"A key question is, if xenotransplantation can relieve significant suffering or even save lives, does this outweigh the potential hazards, such as transferring diseases from animals to humans and onto other humans? "If xenotransplantation were simply a risky trial treatment, it might be that individual consent would be enough to justify the risk. But the risk of xenotransplantation to public health cannot be justified merely on the grounds of individual consent. If this were the case we would have a set of techniques that potentially helps a large number of badly-off people but potentially threatens the health of a very large number. "The risk of disease spreading might be reduced by forcing xenograft recipients to submit to lifelong monitoring and treatment, breaching confidentiality, preventing their reproducing, and compulsorily quarantining them. These measures appear to infringe on rights, so the ethical question is: would this be justified?" says Wilkinson. Alternative uses of xenotransplantation include using brain cells to treat Parkinson's disease (which is currently untreatable) and inserting whole organs like pancreas, kidneys and hearts. It is also possible to undertake therapies outside the body, such as sending the blood of a person with acute liver failure through a type of dialysis machine and back. Growing human cells on layers of animal cells is also an option for treatment of such conditions such as motor neurone disease. All of these are at an experimental stage - some much further along than others.

Xenotransplantation is effectively blocked in New Zealand at the moment, largely for reasons of public safety. Australia has recently blocked xenotransplantation research for at least five years. Canada has also blocked it. The US and the UK permit it, although the UK has a very high barrier. China and Mexico are doing xenotransplantation on a relatively large scale.

"Concerns about xenotransplantation do not stop with public health risks. There are cultural considerations about animal cells introduced into humans, particularly live cells. Does this affect our essential humanness? Is it part of a desperate grab for immortality that humans cannot possibly achieve?" says Wilkinson. The Bioethics Council is encouraging public discussion around the cultural, ethical and spiritual dimensions of xenotransplantation and is looking at the individual and community points of view. It will provide independent advice to Government on its findings. The deadline of 20 May for the online forum and submissions process is fast approaching and the Council will then enter the final stage of assessing the feedback.

Results will contribute towards a report on the cultural, ethical, and spiritual aspect of xenotransplantation in September.

For further information about diabetes see www.diabetes.org.nz and www.bioethics.org.nz

ENDS

To stimulate discussions and inform people of the issues around xenotransplantation before the dialogue process, the Council launched a discussion document in February entitled "The Cultural, Spiritual and Ethical Aspects of Xenotransplantation: Animal-to-Human Transplantation" - it can be found at www.bioethics.org.nz .

Public are also invited to become involved in one or more of the following activities which will be taking place between March and 20 May 2005:

* Visit www.bioethics.org.nz for background info and links to more detailed background research

* Join the online discussion forum, to register, log on to www.bioethics.org.nz/dialogue/forum/

* Make a submission by mail, email or online. There is a submission form on our website, or just send a letter or email.

* Get together with whanau, friends or workmates and have a discussion. We want people thinking and talking about these topics, even if you do not end up writing anything down. Our website has links to ideas on running dialogue groups.

[Investment Biker]

Does this affect our essential humanness?

How stupid is this question? I had bacon today and I did not ask if it impacted my humanness? When individuals have porcine heart valves implanted do they ask this question? Do they ask the question if living attached to an insulin pump machine affects my essential humanness? Do they ask if taking insulin generated by bacteria impacts my humanness? The only thing that impacts my humanness is stupid questions asked by meaningless ethics personnel.

Is it part of a desperate grab for immortality that humans cannot possibly achieve?"

No you dumb a$$ is is a rational attempt to live a normal life. What a DUMB A$$

[John Jorsett]

Haven't we been using pig heart valve transplants for a few decades?

[Investment Biker]

That is correct. But pig heart valves are not live cell transplants. At least that is my layman's understanding. Wereas insulin producing islet cells are live. They ahve already been transplanted into many individuals with no known disease risk.

[politicalwit]

"Haven't we been using pig heart valve transplants for a few decades?"

Not only heart valves but arteries for those on dialysis.

[Cyclopean Squid]

Good read. I doubt if I'd feel comfortable with a transplant, but also recognize that that is probably the closest they will come to a "cure" in the foreseeable future. It should definately be an option for those who are interested.

I am quite happy with my pump, aka my pancreas on a belt, for the present time. But who knows, once the transplant procedure is perfected I might have to look into it. I definately wouldn't have wanted the first model pumps (which looked like a hiker's backpack), but I can't imagine living without the current model.

I give much credit to the first wave of patients who try out revolutionary medicine. I am much happier being in the third or fourth wave myself.

[jim_trent]

Until about 10-15 years ago, insulin dependent diabetics (Type 1) depended primarily on pig insulin. Some on beef insulin, but not nearly as much. In fact, the early "human" insulin (which is not from humans) was not as good as the pig insulin. If it was not for animals, diabetics between the 1920's and the 1980's would have died just like all diabetics before them.

I say, bring it on!

[M. Dodge Thomas]

Well, if you’re down with the basic concept you've got your choice of research programs: xenotransplantation, or the cloning of entirely human replacement organs.

Myself, I’d prefer to get my spares from a decephelated clone rather (for example) than as material of porcine origin.

But for a lot of people, the squick factor is going to be pretty formidable either way.

[Investment Biker]

Here is the real rub behind this. A company that was in NZ was trying to adapt encapsulation technology to be able to transplant these cells without the use of immune suppression. Just put the cells into the capsule insert cells into the portal vein of liver and you are cured at least for a couple of years. NZ nixed them and they went to Mexico City and had it done with a very crude system that did not encapsulate but used testicle cells to protect them from the immune system. These experiments had limited success.

Then they moved to Australia. Aussies then produced regulations to stop them from going forward with their new company LCT technologies. LCT has one of the more promising encapsulation technologies and has performed one human cell transplant in the Italy at the University of Perugia using encapsulation. But there simply are not enough human cells. Estimates are that if they could recover every cell they could only cure less than 1/2 of one percent of T1 diabetes. That is why xeno is so important. It can only be stopped by the heavy hand of government.

[Investment Biker]

Two comments regarding cloning. One is there is considerable ethical resistance to creating life simply for spare parts. I for one could not do it.

Second, if I could relax my ethics, cloning and development of spare parts through the process is decades away. Pigs cells exist today and could be used very quickly to cure most T1 diabetes.

[Investment Biker]

You are correct that until the introduction by Lilly of recombinant DNA insulin the insulin of choice was porcine. Bovine was used by many but was not as common as porcine. The original inventor of insulin gave away the patents to a meat packing area so that insulin could rapidly reach those that were dying from diabetes. That is why Lilly is in Indianapolis, a former meat packing town.

[Born Conservative]

Not only heart valves but arteries for those on dialysis.

They also used cow's arteries for dialysis; my mother had a "bovine graft" back in the late 70's.

[struggle]

Diabetic Freeper here too. I only have been diabetic for 5 years, so let the 20-30 year survivors take the new stuff.

Frankly, I think the best stuff sounds like the of stem cell-beta cells inside a ball of immune reaction preventing membrane. That got tried out recently. No immuno-suppression.

[null and void]

Don't hold back, tell us how you really feel...

[null and void]

I give much credit to the first wave of patients who try out revolutionary medicine. I am much happier being in the third or fourth wave myself.

Aye yup.

The early bird gets the worm, but it's the second mouse that gets the cheese...

[Investment Biker]

I think the best stuff sounds like the of stem cell-beta cells inside a ball of immune reaction preventing membrane. That got tried out recently.

No stem cell has been shown to be changed and behave like the body's natural islets (beta cells). Many are trying but many, many questions and much research remain. Then there is the ethical questions. So rather than wait a decade and have to compromise my ethics I would use pig cells in a heartbeat. The encapsulation has recently been tried by one company in Italy and another less promising company in Toronto. The Toronto Company claims to have functional system for producing the cells. None of their claims have been peer reviewed. Another company is trying to raise $2.5 million for preclinical studies.

[Sloth]

My 23-year-old wife has a synthetic conduit with a dead human valve in it acting as part of her pulmonary artery (it was replaced with a new one about a year ago due to calcification of the valve she had implanted at age 8). Anyhow, the conduit also has a bovine vessel segment at the end, to fuse with her own tissue I assume.

Sometimes I call her a cannibal when she eats steak. :)

[struggle]

AmCyte Announces First North American Encapsulated Islet Transplant without Long-Term Immune Suppression into a Patient with Type 1 Diabetes

Press Release

LOS ANGELES, March 9, 2005--AmCyte Inc., a leader in encapsulated islet replacement and pancreatic adult stem cells, announced today the transplantation of the first Type 1 diabetic patient in North America to receive islets without long-term immune suppression.

The transplant took place on February 22nd at Toronto General Hospital. The patient experienced no complications during the minor 20-minute surgical infusion. The patient was released from the hospital three days after the procedure and is resting at home.

The transplanted islets are protected from rejection by the patient's immune system with AmCyte's novel microencapsulation technology. About the size of a pinhead, each clear gel bead contains multiple islets, and floats freely in the patient's abdominal cavity. The capsules are permeable so that nutrients and glucose can get to the islets, and secreted insulin from the islets can get out into the blood.


"At this point we are very happy that the patient is doing well," said Oliver Foellmer, AmCyte's Director of Business Development. "The clinical trial represents a new generation of islet transplantation technology and is part of a multi-prong clinical trial strategy to bring a treatment for diabetes to the market."

"We are excited to contribute this important step towards a treatment for diabetes without the health risks of immune suppression," said Dr. Wen G. Tsang, Sr. VP R&D. "In conjunction with our Adult Stem Cell Regenerated Islet Program, we look forward to being able to address both the limitations of immune suppression and islet supply."

[Investment Biker]

Yea and I would be afraid that anytime someone told a bovine or pig joke I would not be able to laugh but would rater snort like a pig. Oh well, I could live with that - snort snort.

[ATOMIC_PUNK]

Tell ya what I've got type 2 and if i thought it would get rid of it i would do it in a heartbeat we use animals for virtually everything under the sun why not this ?

[Investment Biker]

I do not trust Amcycte. Their forerunner were involved with Mylan Labs years ago. The forerunner was the first to transplant cells in a human using Vivorx encapsulation. Steven Craig was the man's name. He committed suicide and Mylan eventually sued Vivorx. I simply do not trust them.