Clinical Islet Transplant Program

Edmonton, Canada

Clinical Islet Transplant Program

Edmonton, Canada
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"The loss of insulin-producing beta cells leads to type 1 diabetes, making it an ideal target for cell replacement therapy," said James Shapiro, MD, PhD, FRCSC, Director of the Clinical Islet Transplant Program, University of Alberta.  "Islet transplants from scarce organ donors have offered great promise for those with unstable, high-risk type 1 diabetes, but the procedure has many limitations.  With an unlimited supply of new islets that the stem cell-derived therapy promises, we have real potential to benefit far more patients with islet cell replacement." The PEC-Direct product candidate delivers stem cell-derived pancreatic progenitor cells, called PEC-01™ cells, in a device designed to allow direct vascularization of the cells in the device.  After implantation, these cells are expected to proliferate and mature to human islet tissue including well-regulated beta cells producing insulin on demand.  The direct vascularization of the implanted cells is expected to allow for robust and consistent engraftment but will necessitate the use of maintenance immune suppression therapy. The PEC-Direct product candidate is being developed for type 1 diabetes patients who have hypoglycemia unawareness, extreme glycemic lability, and/or severe hypoglycemic episodes.  It is estimated that about 140,000 people in Canada and the U.S. have such high-risk type 1 diabetes.  In addition to providing an unlimited supply of cells for implantation, the PEC-Direct approach has the potential to provide other advantages relative to cadaver islet transplants such as delivering a more consistent product preparation under quality-controlled cGMP conditions, with a more straightforward and safer mode of delivery. "ViaCyte was the first to differentiate human stem cells into glucose-responsive, insulin-producing cells, and now we are running the first and only clinical trials of stem cell-derived islet replacement therapies for type 1 diabetes," said Paul Laikind, PhD, President and CEO of ViaCyte.  "While insulin therapy transformed type 1 diabetes from a death sentence to a chronic illness, it is far from a cure.  Type 1 diabetes patients continue to deal with the daily impact of the disease and remain at risk for often severe long-term complications.  This is especially true for the patients with high-risk type 1 diabetes, who face challenges such as hypoglycemia unawareness and life-threatening severe hypoglycemic episodes.  These patients have a particularly urgent unmet medical need and could benefit greatly from cell replacement therapy." "Those living with hypoglycemia unawareness are at constant risk of life-threatening complications, and even death, because they do not sense the physical symptoms of low blood sugar," said Dr. Jeremy Pettus, Principal Investigator of the clinical trial and Assistant Professor of Medicine at UC San Diego.  "An islet cell replacement therapy could be significant for patients with this type of high-risk diabetes."  At UC San Diego, the trial will be performed at the School of Medicine's Altman Clinical Trials Research Institute with support from the California Institute for Regenerative Medicine (CIRM)'s Alpha Clinic and the Sanford Stem Cell Clinical Center. PEC-Direct is one of two product candidates in clinical development to treat patients with diabetes.  ViaCyte's PEC-Encap™ (also known as VC-01) product candidate delivers the same cell therapy as PEC-Direct but uses a proprietary device called the Encaptra® Cell Delivery System that is designed to protect the cells from the patient's immune system.  The PEC-Encap product candidate is being developed as a transformative therapy for all patients who require insulin to control their disease.  Early clinical evidence with the PEC-Encap product supports the potential of the replacement cell therapy approach.  However, the clinical results also indicate that further work to optimize the performance of the PEC-Encap product is required.  ViaCyte recently announced a collaboration with W. L. Gore & Associates focused on modifying the Encaptra device to improve engraftment in patients. About PEC-01 Cells ViaCyte's PEC-01 cells are the biological component of both PEC-Direct and PEC-Encap product candidates.  PEC-01 pancreatic progenitor cells are manufactured from pluripotent stem cells and are designed to further differentiate and mature after implantation, not only to fully functioning insulin-producing beta cells, but also to the other endocrine cell types that make up the normal healthy human pancreatic islet.  This mixture of pancreatic cell types is expected to produce on-demand the necessary insulin, along with other hormones that are important for the regulation of glucose (sugar) in the blood including glucagon, somatostatin, and amylin. About ViaCyte ViaCyte is a privately-held regenerative medicine company developing novel cell replacement therapies as potential long-term diabetes treatments to reduce the risk of hypoglycemia and diabetes-related complications.  ViaCyte's product candidates are based on the derivation of pancreatic progenitor cells, which are then implanted in a durable and retrievable cell delivery device.  Once implanted and matured, these cells are designed to secrete insulin and other pancreatic hormones in response to blood glucose levels.  ViaCyte has two products in development.  The PEC-Direct™ product candidate delivers the pancreatic progenitor cells in a non-immunoprotective device and is being developed for type 1 diabetes patients who have severe hypoglycemic episodes, extreme glycemic lability, and/or impaired awareness of hypoglycemia.  The PEC-Encap™ (also known as VC-01) product candidate delivers pancreatic progenitor cells in an immunoprotective device and is currently being evaluated in a Phase 1/2 trial in patients with type 1 diabetes who have minimal to no insulin-producing beta cell function.  ViaCyte is headquartered in San Diego, California.  The Company is funded in part by the California Institute for Regenerative Medicine (CIRM) and JDRF. For more information on ViaCyte, please visit www.viacyte.com and connect with ViaCyte on Twitter and Facebook. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/viacyte-receives-ind-allowance-from-fda-and-clearance-from-health-canada-to-commence-international-clinical-trial-of-pec-direct-cell-therapy-for-high-risk-type-1-diabetes-300461166.html


Schwindt S.T.,University of Alberta | Hubert G.,Clinical Islet Transplant Program | Koh A.,Clinical Islet Transplant Program | Shapiro A.M.J.,Clinical Islet Transplant Program | And 2 more authors.
Canadian Journal of Diabetes | Year: 2012

Clinical islet transplantation (CIT) has emerged as an effective therapy for type 1 diabetes mellitus. Adults undergoing CIT are at high risk for reduced bone mineral density (BMD) due to poor nutritional status, use of immunosuppressive therapy known to influence bone metabolism and ongoing refractory disease. The objective of this study was to determine the prevalence of reduced BMD in CIT recipients. A retrospective pair-matched study design was conducted in adults with type 1 diabetes pre- and post-CIT (n=18). BMD was measured using dual x-ray absorptiometry (DXA) at the femoral neck (FN), hip and spine. Overall, absolute BMD (g/cm2) did not decrease significantly between pre- and post-CIT measures (p>0.05). Routine evaluation of BMD including variables known to influence bone health (medications, lifestyle factors), is warranted in patients undergoing CIT. © 2012 Canadian Diabetes Association.


PubMed | University of Alberta and Clinical Islet Transplant Program.
Type: | Journal: Diabetic medicine : a journal of the British Diabetic Association | Year: 2016

Resuming insulin use due to waning function is common after islet transplantation. Animal studies suggest that gastrointestinal hormones, including gastrin and incretins may increase -cell mass. We tested the hypothesis that pantoprazole plus sitagliptin, would restore insulin independence in islet transplant recipients with early graft insufficiency and determined whether this would persist after a 3-month washout.Single-centre, uncontrolled, open label study of sitagliptin 100mg daily plus pantoprazole 40mg twice daily for 6months.After 6months of treatment, two of eight participants (25%) achieved the primary endpoint, defined as HbASitagliptin plus pantoprazole is well tolerated and safe and may restore insulin independence in some islet transplant recipients with early graft insufficiency, but this was not sustained when treatment was withdrawn. A larger, controlled trial is required to confirm the effectiveness of this combination to achieve insulin independence and to confidently exclude any persistent benefit for graft function. (Clinical Trials Registry No.: NCT00768651) This article is protected by copyright. All rights reserved.

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