Possible Cures for Type-1 in the News (September)

Unsuccessful Phase-I Clinical Trial of Beta-O2's Encapsulated Beta Cells 

Encapsulated beta cells are implanted devices.  The encapsulation coating allows blood sugar in, and insulin out, but does not allow the body's immune system to attack the beta cells. It also allows nutrients in and waste products out. This allows the beta cells to naturally grow and to react to the body's sugar by generating insulin which goes into the body's blood system. Meanwhile, the body's autoimmune attack cannot target these beta cells, and you don't need to take any immunosuppressive drugs (as you would for a normal beta cell transplantation).  I previously blogged about this trial here:
https://cureresearch4type1diabetes.blogspot.com/2014/11/beta-o2-starts-phase-i-trial-and-update.html

Unfortunately, they published unsuccessful results last year.  To quote their abstract:

Implantation of the βAir device was safe and successfully prevented immunization and rejection of the transplanted tissue. However, although beta cells survived in the device, only minute levels of circulating C-peptide were observed with no impact on metabolic control. 

Encapsulated beta cells have been an active area of research for over 20 years.  Currently ViaCyte and Sernova are both active in clinical trials in this area, and there are other contenders testing in animals.

Abstract: https://www.ncbi.nlm.nih.gov/pubmed/29288549
Full Paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055594/
Clinical Trial Record: https://www.clinicaltrials.gov/ct2/show/NCT02064309

The Phase-II? Clinical Trial of Ladarixin Is Fully Enrolled

Ladarixin targets two specific immune system chemicals: IL-8a and IL-8b. The idea behind this trial is that suppressing this part of the immune system will stop the autoimmune attack which causes type-1 diabetes.  I previously blogged about this study here:
https://cureresearch4type1diabetes.blogspot.com/2016/08/ladarixin-starts-phase-ii-clinical-trial.html

This study finished recruiting in June-2018, and they now expect to complete in Oct-2019.
Clinical Trial Record: https://www.clinicaltrials.gov/ct2/show/NCT02814838

Fully enrolled is an important milestone for two reasons.  First, because it is now possible to predict when they will finish collecting data.  Second, because much of the uncertainty that surrounds clinical trials, is involved with recruiting participants.  It is often unclear how hard it will be to recruit people, and how long it will take.  But that this point, all that uncertainty is behind the researchers.  From now on, it is just gather data, then analyze data, and then publish data.  Researchers have a lot more control over those later stages, then over recruiting people in the first place.

Coffee In Pilot Clinical Trial To Improve Renal Function

I will not be following this trial, because it is aimed at long term complications of T1D, not a cure.  But it sounded like so much fun, I'm mentioning it here.  Apparently caffeine changes renal (kidney) function in some unique ways which are not duplicated by other drugs.  The researchers think that a coffee in the morning might improve kidney function in a way that helps people with T1D.

They are testing this in teenagers (12-21 years old).  It is a 10 person, open label, no control group trial, which is enrolling by invitation only.  You need to already be participating in a different trial (called "CASPER") to get invited.  They drink Starbucks® cold brew every morning for 6 days.  Kidney function will be tested on the 7th day.  No word on the Peet's® version.

Clinical Trial Registry: https://clinicaltrials.gov/ct2/show/NCT03878277

Joshua Levy 

http://cureresearch4type1diabetes.blogspot.com 

publicjoshualevy at gmail dot com 

All the views expressed here are those of Joshua Levy, and nothing here is official JDRF or JDCA news, views, policies or opinions. My daughter has type-1 diabetes and participates in clinical trials, which might be discussed here. My blog contains a more complete non-conflict of interest statement. Thanks to everyone who helps with the blog.

Beta-O2 Starts a Phase-I Trial (and an update on encapsulated beta cells generally)

Introduction to Encapsulated Beta Cells

Encapsulated beta cells are implanted devices.  The encapsulation coating allows blood sugar in, and insulin out, but does not allow the body's immune system to attack the beta cells. It also allows nutrients in and waste products out. This allows the beta cells to naturally grow and to react to the body's sugar by generating insulin which goes into the body's blood system. Meanwhile, the body's autoimmune attack cannot target these beta cells, and you don't need to take any immunosuppressive drugs (as you would for a normal beta cell transplantation).  The cells inside the coating are human beta cells, and different companies get their beta cells from different sources.

Beta-O2 Starts a Phase-I Clinical Trial

Beta-O2 is starting a phase-I clinical trial of their "ßAir Bio-Artificial Pancreas" (encapsulated beta cell) device as a possible cure for type-1 diabetes.  The devices itself is similar to other encapsulated beta cell devices (ie. Diabcell by LCT, Encaptra by ViaCyte, etc.) with one important difference: the device is injected with oxygen once a day.  This is a manual step performed by the patient.  The company claims it will take about 2 minutes, and provides pictures of the device used, which looks like a needle attached to tubing.  You can read about the device here: http://beta-o2.com/living-with-sair/

The clinical trial is pretty standard for a phase-I trial: 8 people will use the device for 6 months, and be followed for an additional 6 months.  They will test for safety and effectiveness (C-peptides, Insulin usage, and A1c numbers), and hope to finish in March 2016.

The clinical trial is being run by the Uppsala University Hospital.  Contact information is: Per-Ola Carlsson, MD, PhD  Phone number:  +46 18 4714425  Email:  Per-Ola.Carlsson@mcb.uu.se.  This trial is for adults with long established (5 years or more) type-1 diabetes.  One unusual requirement for this trial is that patients must start out using 1 unit of insulin per day per kilo of weight (or less).

The clinical trial is expected to cost about US$ 1 million, with JDRF paying for half.

Press release: http://www.fiercemedicaldevices.com/press-releases/first-patient-successfully-implanted-safetyefficacy-study-beta-o2s-air-bio
Clinical Trial Record: http://clinicaltrials.gov/ct2/show/NCT02064309

Other Encapsulated Beta Cells Research Underway

Interest in encapsulated beta cells seems to be cyclical.  When my daughter was first diagnosed, about 10 years ago, encapsulated beta cell devices were a strong area of research.  But one by one, most of the devices failed.  We then went through several years with only one company (LCT) in human trials.  Now, however, interest appears to be picking up with a new generation of human trials underway.  Here is a quick summary of the encapsulated beta cell devices that I know of:

Beta-O2: Just started a phase-I clinical trial.
Viacyte: Just started a phase-I clinical trial.
LCT: Has been doing phase-II trials for several years, but has not made any forward progress (in terms of better results), in years.
Hospital St. Luc research project: Completed (?) a phase-I trial, but not sure about any progress recently.
AZ-VUB: In phase-I, but I don't know any details.
DRI Biohub: Started clinical trials for infrastructure for such a device, but still using immunosuppression.
Sernova: Started clinical trials for infrastructure for such a device, but still using immunosuppression.
Islet Sheet Project: In animal testing.
Harvard Project: In animal testing (?).
Chicago Diabetes Project: Still using immunosuppression.
Nuvilex: Starting animal testing soon.

In my opinion, these are a lot of different research groups, all focused on the same type of cure.  For me, that's good news, because it suggests that many people believe this technology is ready to lead to a cure.  And that makes me optimistic.  Unfortunately, previous "waves" of encapsulated beta cell devices did not lead to a cure, so that makes me nervous.

Background Information

http://en.wikipedia.org/wiki/Cell_encapsulation
https://www.landesbioscience.com/pdf/HunkelerPDF.pdf

Joshua Levy 
http://cureresearch4type1diabetes.blogspot.com 
publicjoshualevy at gmail dot com 
All the views expressed here are those of Joshua Levy, and nothing here is official JDRF or JDCA news, views, policies or opinions. My daughter has type-1 diabetes and participates in clinical trials, which might be discussed here. My blog contains a more complete non-conflict of interest statement. Thanks to everyone who helps with the blog.