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Quarter-sized implant offers promising Type 1 diabetes treatment

Someday, a single, battery-free implant could replace injections as a long-term treatment for Type 1 diabetes and other diseases that need multiple deliveries of therapeutic proteins.

(CN) — A small device could eventually free Type 1 diabetes patients from daily injections or medications to control their condition, according to a study by a Massachusetts Institute of Technology research team published Monday in Proceedings of the National Academy of Sciences.

The team found limitations with the existing methods of treating Type 1 diabetes, where the body does not produce enough insulin to control blood glucose levels.

One of the most well-known methods involves a patient carefully monitoring their blood glucose levels and injecting themselves with insulin at least once a day, but the team says that this is not a complete replication of what the pancreas can do naturally.

Some Type 1 diabetes patients receive transplanted groups of pancreatic cells, called islet cells, from human cadavers for long-term control of the condition, but they have to take immunosuppressive drugs to prevent their bodies from rejecting the implanted cells. One workaround for that method is to put the islet cells in a flexible device that protects them from the immune system, but the cells need a reliable oxygen source that is challenging to obtain, according to the study.

Eventually, the MIT researchers realized that water from the body could be that source of oxygen.

To that end, a quarter-sized device uses a proton-exchange membrane, technology originally deployed to generate hydrogen in fuel cells. Requiring only two volts, the proton-exchange membrane splits water vapor found throughout the body and harmlessly diffuses it away. Meanwhile, the oxygen goes into the device’s storage chamber, which feeds the islet cells through a thin, oxygen-permeable membrane.

Optical image of cathode side of fully assembled O2-Macrodevice showing, with a United States quarter-dollar coin for scale. (Claudia Liu and Dr. Siddharth Krishnan, MIT/Boston Children’s Hospital)

A wireless power transfer occurs between a small, flexible antenna within the device and a tuned magnetic coil outside the body, the latter of which patients can wear as a patch on their skin, eliminating the need for wires or batteries.

Researchers found that diabetic mice with the oxygen-generating device maintained normal blood glucose levels comparable to healthy animals. Mice with the non-oxygenated device became hyperglycemic within about two weeks.

The oxygen-generating device succeeded despite coming under attack from the body's immune system, resulting in scar tissue that lessened the system's effectiveness, said the study’s senior author, Daniel Anderson, in an email.

“Fibrosis (scar tissue) commonly forms around implanted medical devices," Anderson said. "When cells are present in a device, this can lead to oxygen depletion. Since this device creates oxygen, we found that the cells within the device were able to stay alive even in the presence of fibrosis."

Anderson emphasized that future devices will focus on resolving the problems created by scar tissue.

"Regardless, we have also worked extensively on reducing fibrosis to medical materials and are currently investigating approaches to reduce fibrosis in a next generation device,” said Anderson, a professor in MIT’s Department of Chemical Engineering, and a member of MIT’s Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science.

With these results in mind, the researchers' next step is to test the device on larger animals before adapting it for human use. The team says the next device should last longer and be about the size of a stick of chewing gum. Furthermore, the researchers hope that a similar device will be useful to patients with other ailments seeking treatment beyond injections.

“The device contains cells that can be engineered to produce a broad range of therapeutic proteins," Anderson said. "In the paper, we demonstrate this concept with a model protein system, erythropoietin. Accordingly, we believe that this class of encapsulated cell technologies could be used to treat several conditions that require chronic protein administration, such as clotting disorders, degenerative neural disease and several others."

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