Diabetes may be reversible!

In recent years, the team of Wang Wei , a professor at the Third Xiangya Hospital of Central South University and director of the Hunan Provincial Xenotransplantation Engineering Technology Research Center , has made a series of major breakthroughs in porcine islet transplantation .

The Third Xiangya Hospital of Central South University Wang Wei Wang Wei of the Third Xiangya Hospital of Central South University

According to the latest data released by the International Diabetes Federation (IDF), about 537 million adults (20-79 years old) worldwide will have diabetes in 2021, accounting for about one tenth of the adult population, of which 140 million Chinese have diabetes

In 2021, about 537 million adults (20-79 years old) in the world will suffer from diabetes, accounting for about one tenth of the adult population, of which the number of diabetic patients in China will reach 140 million .

"2021 IDF Global Diabetes Map (10th Edition)" data (Source: IDF official website)

"2021 IDF Global Diabetes Map (10th Edition)" data (Source: IDF official website) "2021 IDF Global Diabetes Map (10th Edition)" data (Source: IDF official website)

We know that diabetes is a chronic, systemic metabolic disease and every patient with type 1 diabetes (T1D) and many with type 2 diabetes (T2D) requires insulin to control blood sugar levels

However, for some patients with severe type 1 diabetes, the medical community cannot effectively treat them with the traditional method of injecting insulin

The continuous development of xenotransplantation, the domestic pioneer of the Third Xiangya Hospital

The development of xenotransplantation, the domestic pioneer of the Third Xiangya Hospital , the continuous development of xenotransplantation, the domestic pioneer of the Third Xiangya Hospital

We humans have carried out "crazy" explorations of transplanting animal organs into humans many years ago.

Since then, doctors have also tried sheep pancreas fragment transplantation, chimpanzee testicular and ovary transplantation, etc.

In the 1990s, European and American countries made great efforts to promote pig organ transplantation projects, and several global pharmaceutical companies also invested heavily in the hope of solving the problem of human rejection of pig organs

Wang Wei, Chief Physician of the Third Xiangya Hospital of Central South University, Professor of Imaging Medicine, Deputy Director of the National Stem Cell Engineering Research Center

In 1995, when interventional radiotherapy began to be applied to the treatment of diabetes, Professor Wang Wei of Xiangya Hospital, a radiologist at the time, began to think about whether it is possible to fundamentally solve the problem of pancreatic islets in patients with type I diabetes through xenotransplantation through interventional methods.

Faced with the problem of how to remove porcine endogenous retrovirus (PERV), Wang Wei used the screening method

Approved by the Ministry of Health, from 2000 to 2004, Wang Wei's team completed a total of 22 cases of "pig-human" pancreatic islet transplantation clinical trials for diabetic patients, and achieved obvious curative effects

According to "Science of China", in May 2005, the ninth annual meeting of the International Association of Pancreatic Islet Transplantation was held in Geneva, Switzerland

Professor Carl Gross, former chairman of the Nobel Prize in Physiology or Medicine jury, praised Wang Wei for his "pioneering work" in the field of xenotransplantation

Wang Wei Wang Wei Pioneer of Xenotransplantation Pioneer of Xenotransplantation

Clinical research continues to make breakthroughs, and islet extraction progresses smoothly

Continuous breakthroughs in clinical research, smooth progress in islet extraction , continuous breakthrough in clinical research, smooth progress in islet extraction

After the initial pioneering achievements, Professor Wang Wei's team has made a series of new breakthroughs on the basis of the original research for 10 years, and established a complete technical system of transplantation donor culture-porcine islet extraction-clinical application for the first time in the world

In 2008, Central South University introduced investors to establish Hunan Sino Biotechnology Co.

At the same time, in order to solve the immune rejection reaction, the scientific research team and the University of Sydney in Australia have created an internationally advanced new technology for inducing immune tolerance for 10 years
.
The core of this new technology is to "train" T cells.
Through in vitro training, let them know that the transplanted porcine islet cells are "friends" rather than "enemies", and then recycle them into the patient's body, which can greatly reduce the use of anti-rejection drugs and improve transplantation.
effect
.

In January 2013, the Hunan Provincial Department of Health organized an expert group composed of first-class scholars from various disciplines in the country to review the "Clinical Research Program of Neonatal Pig Islet Transplantation for Type I Diabetes with Small Samples" chaired by Professor Wang Wei, and the review passed the clinical study.
The program agreed to carry out this study, which is a major step in xenotransplantation from basic research to clinical research
.

From July 2013 to February 2016, the Cell Transplantation and Gene Therapy Research Center of the Third Xiangya Hospital of Central South University adopted the new technology of inducing immune tolerance, and successively carried out the transplantation of "five-star pig" islets for 3 patients with type I diabetes.

.
The insulin dose of one transplant patient was reduced by 80.
5%, and hemoglobin had completely returned to normal; the insulin dose of the other two transplant patients was reduced by 57% and 56%, respectively, and the glycated hemoglobin also decreased
.

The efficacy of islet cell transplantation after islet cell transplantation was evaluated by the internationally accepted islet graft function function (TEF) (higher than 0.
1 was considered effective).
0.
99 points, far exceeding the results in the field of international islet xenotransplantation research in the same period, ranking first in the world
.

In April 2016, the mid-term review organized by the Hunan Provincial Health and Family Planning Commission believed that the clinical research results of xenotransplantation in the Third Xiangya Hospital of Central South University had reached the international leading level, and they agreed to continue to expand the sample for the next stage of research.
Type Ⅱ diabetes is included in the clinical research scope of xenogeneic neonatal porcine islet transplantation
.

From 2013 to 2017, the team of Professor Wang Wei and Mo Zhaohui conducted clinical research on porcine islet transplantation in 10 patients with type I diabetes
.
Compared with preoperative, the patient's overall insulin use was reduced by more than 60%, and the best effect was reduced by 90%
.
According to the internationally recognized comprehensive score of islet transplantation, the average score is 0.
62, and the highest score is 0.
88 (1 score for complete cure of diabetes), which is much higher than the maximum efficacy of 0.
17 in Japan
.

In September 2017, organized by the Hunan Provincial Medical Association, the industry's top domestic experts conducted a final expert review of the "Clinical Study of Neonatal Pig Islet Transplantation in the Treatment of Type I Diabetes with Small Samples"
.
The evaluation believes that the clinical research of Wang Wei's team has achieved the best curative effect of islet xenotransplantation in the world, and can be applied to the treatment of type 1 diabetes, reaching the international leading level
.
It is recommended to incorporate xenotransplantation of islet transplantation into the management of three types of medical technologies, and to formulate corresponding clinical application technical specifications to promote the clinical application of this technology
.
This marks the world's top technology from the ivory tower to millions of ordinary patients
.

Central South University released the innovative research results of pig islet transplantation in the treatment of type 1 diabetes (Source: Central South University News Network)

Central South University released the innovative research results of porcine islet transplantation in the treatment of type 1 diabetes (Source: Central South University News Network) Central South University released the innovative research results of pig islet transplantation in the treatment of type 1 diabetes (Source: Central South University News Network)

At present, the team cooperates with domestic hospitals and has the ability to treat diabetic patients
.
Xiangya III has established a world-leading large-scale and high-efficiency porcine islet separation and purification system and detection system, which can extract large quantities of porcine islets like an assembly line, and ensure the purity and activity of the extracted islets, opening up opportunities for large-scale transplantation of porcine islets.
broad road
.

The clinical research results of xenotransplantation of islet xenotransplantation by Wang Wei's team from the Third Xiangya Hospital have confirmed the biosafety of islet xenotransplantation in pigs.
This advantage has also been recognized by the World Health Organization
.

As early as 2008, the World Health Organization (WHO) sent a fax to the Ministry of Health after extensive research, saying, "The Central South University team has conducted a pioneering study on porcine islet xenotransplantation in diabetic patients, and the safety is good.
”, suggesting that the Chinese team, the International Xenotransplantation Association and the WHO co-chair the formulation of global xenotransplantation clinical research norms
.

In November 2008, the World Health Organization, the International Xenotransplantation Association, and the Chinese Ministry of Health held a global seminar on clinical research on xenotransplantation in Changsha, Hunan Province.
”), which stipulates the basic principles that must be followed and the basic conditions for biosafety that must be met by all member states of the United Nations to conduct clinical research on xenotransplantation
.

In December 2018, the "3rd Global Xenotransplantation Clinical Research Standardization Seminar" hosted by the World Health Organization of the United Nations and organized by the International Xenotransplantation Association, Central South University and the Third Xiangya Hospital of Central South University was held in Changsha to further improve the clinical practice of xenotransplantation.
Research international standards and support UN member states to safely and effectively conduct clinical research on various types of xenotransplantation such as organs, tissues and cells
.

In 2008 and 2018, the World Health Organization chose to hold the "Global Symposium on Standardization of Xenotransplantation Clinical Research" twice in Changsha, China, which shows that the standardized management of xenotransplantation clinical research by the Chinese government has been recognized by the international community, and it also proves that China In the field of transplantation medicine research, it has assumed the responsibility of a major country with international influence
.

The market prospect of xenotransplantation, when will it be widely used?

The market prospect of xenotransplantation, when will it be widely used? The market prospect of xenotransplantation, when will it be widely used?

The World Health Organization of the United Nations believes that xenotransplantation will be an emerging industry, producing unlimited organ, tissue and cell donor resources for patients in need of transplantation treatment, so that patients in need of transplantation treatment are not limited by the number and time of donors
.

In 2011, The Lancet published a review article titled "Clinical xenotransplantation: the next medical revolution? ".
The authors mentioned that in addition to organs, xenotransplantation can also be used to transplant islets to treat diabetes and neuronal cells to treat nerve cells.
Degenerative diseases such as Parkinson's disease, transplants of liver cells to treat liver failure, transplants of corneal and neural retinal cells to treat various forms of blindness, and even red blood cell transplants for blood transfusions
.

"Clinical xenotransplantation: the next medicalrevolution? "Clinical xenotransplantation: the next medicalrevolution?

The prospects for the xenotransplantation industry are undoubtedly broad
.
On the problem of removing porcine endogenous retrovirus (PERV), the current research hotspot in the scientific community also includes the use of gene editing technology to develop methods for clinical use of xenograft donors
.

At the "3rd WHO Global Xenotransplantation Clinical Research Standardization Symposium" in 2018, world experts reached a consensus that if gene editing technology is to be used to modify the source of xenotransplantation, the modified gene sites should be controlled as few as possible.
Relatively stable within the range
.

On September 21, 2020, Dr.
Yang Luhan of Qihan Bioscience and others published a paper entitled "Extensive germline genome engineering in pigs" in the journal Nature Biomedical Engineering, a sub-journal of Nature, introducing their team's successful development of the first gene using CRISPR gene editing technology.
The first generation of clinical xenotransplantation prototype - "Pig 3.
0"
.
The team is testing the efficacy and safety of the resulting organs in primates
.

Wang Wei believes that "the establishment of gene editing pigs is a very important direction for xenotransplantation".
Wang Wei's team has also carried out gene editing technology to genetically modify pigs, and has formed xeno-2 and xeno suitable for different therapeutic areas.
-3
.
In addition, Wang Wei's team has also completed the experimental study of transplanting neuron cells to treat Parkinson's disease monkeys, and the experimental results also showed good results
.

Organ shortage is a global problem, and the gap will become larger as the aging progresses in the future
.
Islet xenotransplantation has been successful in preclinical research
.
As a realistic and feasible strategy, xenogeneic organs may be the "only strategy" to solve the problem of organ shortage in the future, opening the next medical revolution
.

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