Type 1 Diabetes Clinical Trial
Official title:
A Phase I/IIa Open-label Investigation of the Safety and Effectiveness of DIABECELL® [Immunoprotected (Alginate-Encapsulated) Porcine Islets for Xenotransplantation] in Patients With Type 1 Diabetes Mellitus
The purpose of this study is to establish the safety and efficacy of xenotransplantation of DIABECELL® in patients with established type 1 diabetes mellitus
Intraperitoneal islet transplantation has the potential to ameliorate type 1 diabetes
mellitus and avert the long-term consequences of chronic diabetes which cannot be achieved by
conventional insulin treatment.
As donor human islets are not available in sufficient numbers, porcine islets are the best
alternative source as they are recognised as the most physiologically compatible xenogeneic
insulin-producing cells. Although the use of pig-derived cells raises the risk of xenotic
infections, this can be minimised by obtaining cells from designated pathogen-free (DPF)
animals bred in isolation and monitored to be free of specified pathogens. The worldwide
experience to date in more than 200 patients who have received transplants of pig tissue has
not demonstrated evidence of transmitted xenotic infections.
As animal-derived tissues have to be protected from immune rejection when transplanted into
humans, transplants are usually accompanied by immunosuppressive therapy. However, porcine
islets are preferably transplanted without the use of immunosuppressive drugs which cause
significant morbidity. To protect them from immune rejection, the islets can be encapsulated
in alginate microcapsules which permit the inward passage of nutrients and glucose and the
outward passage of insulin. Alginate-encapsulated porcine islets transplanted without
immunosuppressive drugs have survived rejection for many months in animal studies, and have
been retrieved from a diabetic patient over 9.5 years after intraperitoneal transplantation
and shown to contain viable islets that stain positive for insulin.
DIABECELL® comprises neonatal porcine islets encapsulated in alginate microcapsules.
DIABECELL® has been safely transplanted in healthy and diabetic mice, rats, rabbits, dogs and
non-human primates. Following DIABECELL® transplants, the requirement for daily insulin was
significantly reduced in diabetic rats and non-human primates.
The optimal dose and frequency of transplantation of the current DIABECELL® preparation for
the treatment of type 1 diabetes in humans can only be determined in clinical trials. The
intention of this phase I/IIa clinical trial is to obtain at least 52 weeks safety and
preliminary efficacy data in type 1 diabetic patients following transplantation of two low
effective doses of DIABECELL® into the peritoneal cavity.
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