The Edmonton Protocol
The Edmonton Protocol may sound like a story of espionage and adventure, but it is actually a medical procedure that could be the cure for diabetes. A growing problem in Canada and other industrialized nations, diabetes affects over two million Canadians. There are three main types of diabetes: type 1 (juvenile), type 2 (adult) and gestational diabetes.
Diabetes is a disease in which the body does not produce or properly use the hormone insulin. Insulin is needed to control sugar levels in the blood by converting sugar, starches and other food into energy. The islet cells of the pancreas are responsible for producing insulin. Diabetics can regulate the disease through various avenues including diet, medication and insulin injections, but none of these avenues are a cure.
Developed at the University of Alberta, the Edmonton Protocol is an islet cell treatment system and a potential cure for diabetes. It is a process in which islets cells are obtained from a healthy donor pancreas and introduced into a diabetic patient. A special combination of immunosuppressant drugs follows and allows the transplanted islet cells to take hold.
For many years, researchers have hypothesized that replacing islet cells in diabetics would be the way to beat the disease. However, attempts to do this had not been very successful. When University of Alberta researchers Dr. James Shapiro and Dr. Jonathon Lakey looked into the history of failed islet transplants in diabetics, they concluded that the transplants failed on because the choice of immunosuppression drugs contained steroids that raised sugar levels and destroyed the islet cells.
This observation led the team to develop the Edmonton Cocktail, a revolutionary combination of immunosuppression drugs. Their mixture was highly unorthodox, theoretically dangerous and yet it worked. The cocktail encouraged tissue acceptance without increasing the sugar levels in the patient.
The Edmonton Protocol also involves the highly efficient collection of islet cells from donated pancreases and their transplantation into the diabetic patient. The transplant itself is relatively swift and easy. A catheter is placed into the patient's liver and the islet solution is introduced. It takes less than half of an hour. A second treatment follows.
While the islet separation process is efficient at retrieving the insulin-producers, one patient usually requires three donated pancreases to generate the necessary number of islets. Pancreas donors are in short supply and the two most promising additional areas are taking islets from pigs and stem cells. Stem-cell research is controversial and ethical concerns are widespread. However, in the summer of 2003, the U of A diabetes research team grew insulin-producing beta cells from stem cells. Time will tell if this can be used to make the Edmonton Protocol even more accessible for diabetic sufferers.
The Edmonton Protocol has saved lives and given doctors a new way to combat diabetes. The U of A team has a success rate of more than 70
percent, while the international success rate is above 50 percent. Constantly being refined, this Alberta invention is a giant step towards a cure for diabetes.
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