THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Thursday, May 4, 1995 TAG: 9505040360
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY MARIE JOYCE, STAFF WRITER
DATELINE: NORFOLK LENGTH: Long : 107 lines
Scientists at Eastern Virginia Medical School are chasing a substance they hope will cure some types of diabetes by spurring the body to regenerate destroyed pancreas cells.
The substance, a protein combination called ilotropin, has been found in animals and was used in them to cure artificially induced diabetes, said Dr. Aaron I. Vinik, director of EVMS's Diabetes Research Institute.
Now the question is: Can the researchers find the same type of protein soup in people?
Even if the answer is yes, they say, tests in humans would be years away.
About 14 million Americans have diabetes, an incurable illness that kills about 300,000 people in the United States each year. Although most victims are adults, the disease is also one of most common chronic disorders for children.
It affects almost every major part of the body and can lead to blindness, heart disease, stroke, kidney failure and nerve damage.
Diabetes happens because the body either can't make or can't properly use a hormone called insulin, which is needed to help the body use sugar and other carbohydrates.
Insulin is made by beta cells, which are located in the pancreas, a long gland that sits behind the stomach.
One form of diabetes kills the beta cells. In type 1 diabetes, which accounts for only about 5 percent of all cases, the immune system mistakes beta cells for foreign invaders, and destroys them.
The other type of diabetes, by far the most common, doesn't kill the cells outright but can wear them down gradually. In type 2, which isn't caused by the immune system, the body doesn't get enough insulin, either because the beta cells don't make enough or because the body isn't doing a good job of processing it. Over time, the beta cells weaken under the strain; in 15 percent to 20 percent of people, the cells give up.
Vinik and his colleagues, working with scientists at McGill University in Montreal, hope they can get the body to grow new beta cells to replace those that are lost. Potentially, he says, therapy with ilotropin could help all type 1 sufferers and the estimated 15 percent of type 2 victims who lose their beta cells.
Ilotropin is a mix of proteins that acts as a chemical wake-up call, spurring the pancreas to do what it did before birth, when most beta cells grow.
After birth, the pancreas doesn't create many more beta cells, so it can't offset the destruction of diabetes. But the mechanism to generate new cells is still there, if scientists can find a way to trigger it, Vinik says. He believes ilotropin is that trigger.
He and his colleagues have found the substance in hamsters, he says. In experiments, the animals were given a chemical that made them diabetic. Then they were injected with the ilotropin. Most grew new beta cells - 60 percent grew enough to cure the diabetes, he says.
It's possible that only one of the proteins in ilotropin is the magic bullet that spurs beta cell growth, but they haven't narrowed it down that far, Vinik says.
Now they are looking for ilotropin in humans, or for a gene or genes that trigger the release of that substance.
They're closer to finding the genes in hamsters. That discovery would have important implications for people, because scientists might be able to use the same technique to find the genes in humans, too.
Finding the gene or genes is tricky work, requiring researchers to sort painstakingly through about 70,000 potential candidates. Vinik won't disclose publicly how much they've narrowed it down.
Even if all their experiments succeed, there's still a hitch, at least for people with diabetes caused by a rogue immune system.
Their immune systems might attack the new insulin-producing cells.
But Vinik said that problem may not arise. Someone whose cells have been gone for a long time probably has few of the attacking antibodies remaining in his system.
Or Vinik and his colleagues may benefit from the work of other scientists who are looking at ways to stop that immune response, said Dr. Lawrence Rosenberg, a surgeon who is heading McGill's part in the work.
But those problems are a long way off. Even if all their work goes perfectly, said Rosenberg, they're probably five years away from testing anything on people.
And there are many other researchers around the world looking at different ways to tackle the disease.
``This is obviously down-the-road kind of stuff, but it's the kind of thing that excites people in the research community,'' said Dr. Philip Cryer, vice president of the American Diabetes Association. ``It would be clearly important fundamental information. It would contribute to basic biology but it (also) ultimately could contribute to treatment of the disease.''
Theoretically, the work with beta cells could put doctors like David Scharp out of business. Scharp, until recently a professor of surgery at Washington University School of Medicine in St. Louis, works for a California biotechnology company that is trying to perfect the still-new practice of transplanting clumps of beta cells.
Scharp has used tissue from human donors, but there are so few donors that he's investigating the use of tissue taken from pigs.
``Nothing would make me happier'' than to see Vinik and his colleagues grow new beta cells, said Scharp. ``The area they've chosen to research is very important.''
But Scharp isn't planning to abandon his work any time soon.
``That would be wonderful, if it is possible,'' he said. ``In the meantime, we've got a lot of people with diabetes out there.'' ILLUSTRATION: Graphic by Robert D. Voros, Staff
Diabetes at a Glance
KEYWORDS: DIABETES by CNB