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Book Sale Ends Today!

March Madness Book Sale of My Diabetic Soul – An Autobiography ends today, March 31, 2016 at midnight.

Kindle Edition: $0.00; Paperback: $10.95 signed by the author.

Popular with T1Ds and T2Ds as referenced, this book is a wonderful learning read written by a T1D diagnosed in 1959.

Get your paperback copy at Amazon.com before time runs out!  Other copies are available – full price – at area bookstores and through special orders.

Other books by A. K. Buckroth include: My & My Money…a child’s story of diabetes, Book One  and Me & My Money Too…a child’s story with diabetes, Book Two.

#buckroth

Scientific Research for Health

Deploying the Body’s Army

Using patients’ own immune systems to fight cancer

By Jamie Green and Charlotte Ariyan | April 1, 2014

 Image No 1T CELLS ATTACK: Colored scanning electron micrograph (SEM) of T lymphocytes (green) bound to antigens on a cancer cell. Can researchers harness the killing power of patients’ own immune systems to treat cancer?© STEVE GSCHMEISSNER/SCIENCE SOURCE

More than a century ago, American bone surgeon William Coley came across the case of Fred Stein, whose aggressive cheek sarcoma had disappeared after he suffered a Streptococcus pyogenes infection following surgery to remove part of the large tumor. Seven years later, Coley tracked Stein down and found him alive, with no evidence of cancer. Amazed, Coley speculated that the immune response to the bacterial infection had played an integral role in fighting the disease, and the doctor went on to inoculate more than 10 other patients suffering from inoperable tumors with Streptococcus bacteria. Sure enough, several of those who survived the infection—and one who did not—experienced tumor reduction.1

Coley subsequently developed and tested the effect of injecting dead bacteria into tumors, hoping to stimulate an immune response without risking fatal infection, and found that he was able to cause complete regression of cancer in some patients with sarcoma, a type of malignant tumor often arising from bone, muscle, or fat. Unfortunately, with the increasing use of radiation treatments and the advent of systemic chemotherapy, much of Coley’s work was abandoned by the time he died in 1936.

Today, however, the use of immune modulation to treat cancer is finally receiving its due. Unlike chemotherapy and radiation treatments, which directly attack cancer cells, immunotherapy agents augment the body’s normal immune machinery, increasing its ability to fight tumors. This strategy involves either introducing compounds that directly stimulate the immune cells to work harder, or introducing synthetic proteins that mimic the components of the normal immune response, thereby increasing the body’s entire immune reaction. Last year, cancer immunotherapy was named “Breakthrough of the Year” by the journal Science, placing it in the company of the first cloned mammal and the complete sequencing of the human genome. With a handful of therapies already on the market, and dozens more showing promise in all stages of clinical development, these treatments are poised to forever change the way that we approach cancer management.

The power of the immune response

The human immune system orchestrates processes that continuously survey the host environment and protect it from infection. The two main components of the human immune system, the innate and adaptive arms, work together to fight infection and, importantly, to remember which pathogens the host has encountered in the past. Alerted by danger signals in the form of common microbial peptides, surface molecules, or gene sequences, innate immune cells such as macrophages and neutrophils invoke broad mechanisms to quickly fight foreign invaders. At the same time, B cells of the adaptive immune system generate a highly specific response, creating antibodies that can recognize and clear the pathogens. Antigen-specific T cells, activated by innate immune cells that have ingested the pathogen, further boost the body’s response. These B and T cells have lasting memory, allowing them to generate faster and stronger responses on subsequent exposures.

In the 1960s and ’70s, Lloyd Old of the Ludwig Institute for Cancer Research at Memorial Sloan Kettering Cancer Center (MSKCC) helped rekindle interest in cancer immunotherapy research, finding, among other things, that tumor cells display different surface antigens than healthy cells. These so-called tumor-associated antigens serve as the basis for developing cancer treatment vaccines, which attempt to stimulate a tumor-specific immune response. Old’s discoveries were followed in the 1980s by the work of Steven Rosenberg at the National Institutes of Health. Rosenberg studied the use of cytokines, which normally act to stimulate the immune system, to treat cancer.

More recently, the advent of immune checkpoint blockade approaches pioneered by James Allison, formerly of MSKCC and current chair of the University of Texas MD Anderson Cancer Center Department of Immunology, has written immunotherapy into the oncologist’s playbook. To ensure that the immune system does not become overactive, causing tissue damage or attacking the body, regulatory T cells (or Tregs) and myeloid-derived suppressor cells secrete anti-inflammatory proteins or directly inhibit pro-inflammatory immune cells. Additionally, immune checkpoint proteins expressed on the surface of activated immune cells serve to neutralize the immune response. Tumors may in fact exploit these very anti-inflammatory pathways, perhaps by stimulating an increase in Tregs or increased immune-checkpoint protein expression, to evade recognition by the immune system. Allison is now pioneering techniques to block these checkpoints, allowing the immune response to continue to fight the tumor unhindered.

These exciting new therapies are able to prolong life in patients whose cancers were previously deemed fatal, with kidney cancer and malignant melanoma leading the pack.

Vaccinating to treat cancer

 Image No 2VACCINATING CANCER: Most cancer vaccines in development involve an injection containing a component of a tumor-specific antigen, with the goal of increasing the immune system’s tumor-specific activity. Others, such as Sipuleucel-T, involve the extraction of a patient’s antigen-presenting cells (APCs), which are cultured with antigens from the patient’s tumor along with immune-stimulating factors to prime the APCs to activate T cells in the body.
See full infographic: JPG | PDF
© CATHERINE DELPHIA
Localized injection of Bacillus Calmette-Guérin (BCG), an antituberculosis vaccine made from attenuated live Mycobacterium bovis, was approved for the treatment of bladder cancer in 1990. It was the first immunotherapy approved by the US Food and Drug Administration (FDA) for the treatment of cancer. The idea that tuberculosis or BCG infection could have a role in fighting cancer was first posited in 1929 by Johns Hopkins biogerontologist Raymond Pearl, who noted a reduced incidence of cancer among patients with active tuberculosis at the time of autopsy.2 Old went on to demonstrate in the late 1950s that BCG injections in animal models could reduce tumor growth. Subsequent clinical work in the 1970s and ’80s found that the treatment caused regression of bladder cancers in patients given regular intralesional BCG injections and a 12-fold reduction in bladder tumor recurrence, along with decreased progression and improved survival. Twenty years after its approval, BCG remains the most effective therapy available for the treatment of non-muscle invasive bladder cancer, resulting in the eradication of cancer in 70 percent of eligible patients.

The attenuated bacteria decrease tumor growth by attaching to the bladder tumor and surrounding cells and provoking the infiltration of immune cells, proinflammatory cytokine release, and eventual phagocytosis of cancerous cells by neutrophils and macrophages. While this inflammatory response is efficient at killing tumor tissue, it can also damage the healthy cells of the bladder lining, resulting in side effects that mimic a urinary tract infection, including low-grade fever and pain during urination.2 Researchers are now hoping to avoid the side effects of localized injections by designing novel vaccines that trigger systemic tumor-specific immune responses by binding to proteins unique to tumor cells.

Unfortunately, tumor-specific vaccines have rarely demonstrated significant antitumor activity and survival benefits in humans. So far, only one vaccine of this type is on the market, Seattle-based cancer research company Dendreon’s Sipuleucel-T (or Provenge), approved by the FDA in 2010 as a last-resort treatment for metastatic prostate cancer. In this case, vaccine production involves extracting a patient’s own antigen-presenting cells (APCs), a subset of white blood cells capable of activating T cells, and reinfusing them several days later. While outside of the body, the APCs are incubated with immune-stimulating factors and prostatic acid phosphatase (PAP) antigen, a cell-surface protein found on 95 percent of prostate cancer cells. The APCs then reenter circulation armed to elicit an immune response against the prostate tumor. In randomized controlled trials, the treatment caused a four-month improvement in overall survival for eligible prostate cancer patients.3

Systemic injections of the PAP antigen and similar antigens that target other types of cancer—as opposed to treatment of white blood cells ex vivo as in Sipuleucel-T—have been shown to elicit an immune response in the tumors. But they have not yet been proven to increase survival times. Hundreds of vaccine clinical trials of all stages, including Phase 3 trials for breast cancer, lung cancer, kidney cancer, and melanoma, are now underway to evaluate whether these therapies can indeed boost the cancer-specific immune response and help patients.

Blocking immune inhibition

 Image No 3DON’T STOP FIGHTING: Immune checkpoint blockade therapies work by preventing the immune response from turning off when it normally would. By blocking these immune checkpoints using molecules that bind T-cell surface proteins such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) or programmed death-1 receptor (PD-1), which are expressed on activated T-cells and normally dampen the immune response, the treatments are able to maintain an active immune attack.
See full infographic: JPG | PDF
© CATHERINE DELPHIA
Another exciting and rapidly expanding category of immunotherapy is immune checkpoint blockade. Immune checkpoints are inhibitory pathways that help prevent overstimulation of the immune system. Proteins on the surface of activated immune cells turn off those cells when an immune battle is perceived to be over. The cytotoxic T-lymphocyte antigen 4 (CTLA-4), for example, is normally located inside T cells, but when expressed on the surface, it functions as a “brake” signal to the immune system.

In the mid-1990s, Allison hypothesized that temporary interruption of CTLA-4’s inhibitory effects could augment the immune system and fight tumors. In preclinical models, he demonstrated that treatment with an anti–CTLA-4 antibody was able to cure mice of colon tumors, which can be made to form on the surface of the body by injecting transplantable mouse colon cancer cells subcutaneously.4 Early clinical studies in patients with malignant melanoma demonstrated the treatment’s safety and hinted at its efficacy. In 2010, a large Phase 3 trial showed that blocking CTLA-4 with a humanized monoclonal antibody called ipilimumab (or Yervoy, as marketed by Bristol-Myers Squibb) improved overall survival in patients with late-stage melanoma.5

While the response rate was low, with only about 10 percent of patients showing decreased tumor size after therapy and 18 percent showing stable disease, ipilimumab was the first agent that improved survival in these patients, who typically live only six to nine months from diagnosis when treated with conventional chemotherapy agents. Moreover, the majority of patients who did respond to ipilimumab showed improvement lasting more than two years. The FDA approved the drug for the treatment of advanced melanoma in 2011, and follow-up studies of early trial participants are showing that some patients live up to 10 years after their initial ipilimumab treatment.6 Phase 2 and 3 trials are now testing ipilimumab treatment for numerous other types of cancer, including non–small cell lung cancer, prostate cancer, kidney cancer, and ovarian cancer.

Hundreds of vaccine clinical trials of all stages are now underway to evaluate whether these therapies can indeed boost the cancer-specific immune response and help patients.

The most common adverse events associated with ipilimumab treatment are immune-related and result from the drug’s unleashing of the immune system. They include colitis, dermatitis, and hepatitis, which all result from excessive inflammation. Given ipilimumab’s low response rate, further work is needed to improve this therapy.

One option may be to block other immune checkpoints, such as the interaction between the programmed cell death 1 receptor (PD-1) on T cells and its ligand (PD-L1) on APCs. Similar to CTLA-4, PD-1 is expressed on activated T cells, as well as on “exhausted” T cells that have been shut off despite the persistence of pathogens. When PD-1 binds to PD-L1, the T-cell response is attenuated. Interestingly, in addition to expression on APCs, PD-L1 has also been found on tumor cells, and it is thought to play a role in how tumors are able to evade the immune response. Early results have been promising for Bristol-Myers Squibb’s nivolumab, an anti-PD-1 antibody, in the treatment of malignant melanoma, non–small cell lung cancer, and kidney cancer, and Phase 3 trials are currently under way to investigate the potential survival benefit of this novel agent.7 Similar studies are also being conducted for PD-L1 inhibitors.

Early research testing the combination of anti–CTLA-4 and anti–PD-1 medications also point to the benefits of blocking both immune checkpoints simultaneously. In a study published in collaboration with one of us (Ariyan) in the New England Journal of Medicine last July, more than half of metastatic melanoma patients treated with the maximum combination dose of nivolumab and ipilimumab had a greater than 80 percent reduction in tumor mass, and more than 80 percent of these patients were alive a year after treatment.8 These promising results for a disease with so few treatment options show why immune checkpoint blockade is altering the landscape of cancer therapy.

Transferring T cells

 Image No 4T-CELLS TO THE RESCUE: In adoptive T-cell transfer, T cells isolated from a patient’s blood or tumor are transfected with a virus to express cancer-targeting chimeric antigen receptors (CARs), arming the cells to attack the cancer once reinfused into the patient.
See full infographic: JPG | PDF
© CATHERINE DELPHIA
A third way to boost the immune attack on a tumor is to isolate T cells from a patient, expand them in the laboratory, then reinfuse them into the body as souped-up cancer-fighting agents. Known as adoptive T-cell transfer, the procedure was initially performed using tumor-infiltrating lymphocytes (TIL), a subset of white blood cells that have left the circulating blood and migrated into solid tumors, and which can be isolated from excised tumors. (See “Imagining a Cure,” The Scientist, April 2011.) Unfortunately, disease progression in some patients is too quick to allow the time needed for the extensive ex vivo work, which can take up to a month; but for those who can wait, the therapy may be of some help. In a Phase 2 trial published in 2010, half of 20 patients with stage IV melanoma showed noticeable improvement following treatment, including two complete remissions.9

This strategy is limited, however, in that some patients do not have a lesion that can be excised, or the excised tumor does not have any TILs that grow or that demonstrate antitumor  reactivity in vitro. To circumvent these hurdles, researchers have developed chimeric antigen receptors (CARs) as a method of genetically modifying a patient’s circulating T cells to make them target tumor cells. CARs include an antigen-recognition domain, or modified antibody segment, which is able to recognize a specific protein on the surface of tumor cells, and an intracellular domain that activates the T cell and stimulates in vivo proliferation.10

Researchers have designed CARs to treat a variety of cancers, including chronic lymphoid leukemia (CLL). In one case, they isolated T cells from a CLL patient’s blood and engineered them to express a CD19-targeting CAR. CD19 is a protein that is expressed on the surface of normal B cells, as well as on malignant B cells. After being expanded in vitro, the modified cells were reinfused into the patient, who had failed to respond to all previously available treatment regimens. Following treatment, this patient, and now numerous others, was found to be cancer free.11 (See “Commander of an Immune Flotilla.”)

While there are currently no FDA-approved therapies involving such T-cell manipulations, numerous Phase 1 and 2 trials are underway to determine safety profiles on a larger scale as well as effects on survival for a variety of different cancer types, including leukemia, lymphoma, pancreatic cancer, breast cancer, prostate cancer, and melanoma.

The future of immunotherapy

Immunotherapy is quickly proving itself as a powerful weapon in the fight against cancer, and research continues to further improve the effectiveness of this approach and to broaden the number of patients that are able to benefit from it. Many researchers are currently studying the effects of combining multiple immunotherapy methods, such as immune checkpoint blockade and adoptive T-cell transfer, or cancer treatment vaccines and cytokine administration. In the coming years, it will be exciting to see the profound effects that immunotherapy agents are expected to have on human survival as the hundreds of clinical trials currently interrogating this breakthrough begin to bear fruit. 

Jamie Green is a general surgery resident at New York Presbyterian Hospital-Weill Cornell Medical College and is currently completing a Surgery Research Fellowship at Memorial Sloan Kettering Cancer Center, where Charlotte Ariyan is an assistant attending who is conducting clinical trials on ipilimumab.

References

  1. S.A. Cann et al., “Dr William Coley and tumour regression: a place in history or in the future,” Postrgrad Med J, 79:672-80, 2003.
  2. N.M. Gandhi et al., “Bacillus Calmette-Guerin immunotherapy for genitourinary cancer,” BJU Int, 112:288-97, 2013.
  3. P.W. Kantoff et al., “Sipuleucel-T immunotherapy for castration-resistant prostate cancer,” N Engl J Med, 363:411-22, 2010.
  4. D.R. Leach et al., “Enhancement of antitumor immunity by CTLA-4 blockade,” Science, 271:1734-36, 1996.
  5. F.S. Hodi et al., “Improved survival with ipilimumab in patients with metastatic melanoma,” N Engl J Med, 363:711-23, 2010.
  6. Z. Chustecka, “Some melanoma patients living for up to 10 years after ipilimumab,” Medscape Medical News, Sept 2013.
  7. S.L. Topalian et al., “Safety, activity and immune correlates of anti–PD-1 antibody in cancer, ” N Engl J Med, 366:2443-54, 2012.
  8. J.D. Wolchok et al., “Nivolumab plus ipilimumab in advanced melanoma, ” N Engl J Med, 369:122-33, 2013.
  9. M. Besser et al., “Clinical responses in a phase II study using adoptive transfer of short-term cultured tumor infiltration lymphocytes in metastatic melanoma patients,” Clin Cancer Res, 16:2646-55, 2010.
  10. N.P. Restifo et al., “Adoptive immunotherapy for cancer: harnessing the T cell response,” Nat Rev Immunol, 12:269-81, 2012.
  11. D.L. Porter et al., “Chimeric antigen receptor–modified T cells in chronic lymphoid leukemia,” N Engl J Med 365:725-33, 2011.

Correction (April 2, 2014): This story has been updated from its original version to correctly reflect that James Allison is the current chair of the University of Texas MD Anderson Cancer Center Department of Immunology, not the entire research center; to reflect that modified T cells, not B cells, were reinfused into patients with CLL; and to reflect that cancer vaccines involve the culturing of a patient’s cells with generic tumor antigens that are not specific to the patient’s tumor. The Scientist regrets the errors.

Diabetes Ride For A Cure 2016!

Ride with us toward a world without T1D

With you every mile of the way

Whether you choose to ride 25, 60 or even 100 miles, you’ll be surrounded by the T1D community–fellow riders, coaches, friends and family. You can do this.

Diabetes [International] Advocacy

What Makes JDRF Advocates Stand Out on the Hill?

They keep coming back

They put their day-to-day lives on hold to attend JDRF Government Day because they see the bigger picture—they want to change all lives affected by type 1 diabetes (T1D). Melinda Renfroe, a grassroots JDRF Advocate from Alabama, missed celebrating her daughter’s 23rd birthday on the day because she is here in Washington, D.C., speaking out for Federal support of T1D research progress for her daughter and everyone living with T1D. Melinda told her daughter, Alexandra, “My being at Government Day on your birthday will one day give you the best birthday present ever. A cure.” As a JDRF 2009 Children’s Congress Delegate herself, Alexandra understood, saying “Mom, you’re my hero.”

They’re persistent

Take the Indiana delegation. Cindy Cook, Sharon Gregor, Gartha Ingram and Richard Shevitz will attend a total of 11 meetings in two days. That means they’re meeting with all of the Members of Congress or their staff from their home state. Their secret? “We follow up. We make it easy for them to schedule meetings. And we say thank you,” says Cindy Cook. The grandmother of a high school freshman with T1D, Cindy has been involved with JDRF since her grandson was diagnosed as an infant. For the last seven years, she has witnessed the power of perseverance each time she returns to the Hill and speaks to Members and their staff who remember JDRF and our mission. Representative Susan Brooks (IN-5) recently accepted the position of House Diabetes Caucus Vice Chair, and her office made a special point of reaching out to Gartha to tell him they were inspired in part by him and his son’s story.

They’re passionate

Nobody can deny the energy in the room when our army of volunteers gets together, shares their stories and their successes and heads out the door more determined than ever. Patrick Tohill, JDRF Canada Director of Government Relations, says, “I’m inspired to see how many people want to engage and serve as advocates. I can’t wait to go back home and harness that same energy for T1D research funding and support in my country.”

They take it back home

For JDRF Advocates, the hard work doesn’t end when they leave D.C. Throughout the year they will keep in touch with their Representatives and Senators, tell their stories at JDRF and other community events in their home Districts, and crucially, prepare others to become advocates. “It’s wonderful to go back and tell others how many people in Washington do care and are fighting in our corner,” says Scott Minor, a JDRF New York Advocate. To reach a world without T1D, we must first cover the U.S. map, meet with every lawmaker, and ask each one to promise to remember those who live with T1D when they vote on legislation that will improve lives and lead to a cure. JDRF Advocates are the One Voice that will eventually help us create a world without T1D.

They fight to the finish

“This will end.” Bill Parsons, Executive Director, JDRF Greater Chesapeake and Potomac Chapter, told a fired-up crowd of Advocates before they left for two days of Hill meetings. “If it seems like you’ve been saying the same thing year after year, know that we have made tangible progress, like the SDP renewal, and you have been part of it.”

Are you ready to be part of it? Become a JDRF Advocate by texting “ACT” to 53731 (or JDRF1) or sign up online.

JDRF Government Day Advocates

And keep following #JDRFGovDay to see what makes JDRF Advocates the best of the best.

A special thanks to Sanofi — JDRF 2016 Government Day Presenting Sponsor.

By Cynthia Tully • JDRF
Similar Topics

Move Over, Barbie Doll. There’s Another Doll In Twn!

T1D Community Unites to Make American Girl Dreams Come True

JDRF is very aware of the amazing strength of the type 1 diabetes (T1D) community—and its commitment to improving the lives of everyone affected by this disease. It’s always great to see stories that highlight just how powerful this community really is. You may have heard that American Girl—the popular doll company—recently released a Diabetes Care Kit for their Truly Me™ dolls. But did you know that Matt Wahmhoff, the designer of this groundbreaking kit, also has T1D himself?

MATT_WAHMHOFF_Blog

American Girl dolls reflect the reality of T1D

As of January 2016, everyone affected by T1D now has the option to purchase a Diabetes Care Kit for their American Girl dolls. The kit’s accessories include a blood sugar monitor and lancing device; an insulin pump and infusion set; an insulin pen; a medical bracelet; and glucose tablets. Think of it as a doll-sized version of all the tools necessary to manage this complex disease!

We spoke to Matt—a designer at American Girl —to get his take on how living with the disease informed his experience designing this important kit.

What did it mean to you to design the Diabetes Care Kit?

From a personal standpoint, this is likely one of the most meaningful designs I have ever worked on. The words “meaningful” and “toy” don’t always go together. So, it’s great to have an opportunity to be a part of a designing something like this for American Girl.

Did having T1D yourself influence your design process?

Definitely. When we are designing toys, we’re not always able to achieve every detail we want, but in this case there were important features that I knew had to be right. For example, for me, it was very important how the infusion set attached to the doll to mimic real life as much possible. We looked at many different adhesives and eventually found one that was strong enough to attach to the doll. The spring-loaded feature in the lancet device was another small detail that adds a realistic quality to the device.

Why do you think making this kit available is important?

The kit offers a unique and positive way for a child to deal with the difficulties of caring for his or her diabetes. Teaching their dolls how to care for the disease, like dealing with low and high blood sugar episodes, is a fantastic way to reinforce good everyday practices in diabetes management. And, this can help make girls (and boys!) stronger and more comfortable with their diabetes. It also offers a way for them to teach their friends what it’s like to live with T1D. When I was growing up, most of my friends had no clue what it was like to be diabetic. There just wasn’t a great way to get my friends involved in that part of my life. This kit can really change that now.

What would you like people to know about what it’s like to live with T1D?

People should know that diabetes is manageable and that you can live a very normal life with the disease. You can’t tell if someone has diabetes, which is good, but that can also make people forget that you even have it. Many things besides food can affect my blood sugar level. Everything from exercise, to having the flu, or even stress can raise or lower my blood sugar. So I have to think about what’s going on now—and what I’m going to be doing later—and then decide whether I need to eat, take insulin or both.

What would a world without T1D mean to you?

People with diabetes have a significantly higher risk for certain complications, such as blindness, heart issues, kidney damage and nerve damage. Thankfully, I have not had any of these complications, but they’re always in the back of my mind. So, a world without T1D would be truly amazing for so many people like me. Having to constantly watch my diet and count carbs may be beneficial from a health standpoint, but it sure would be nice to forget about it occasionally!

Girls with T1D across the country rallied behind Anja Busse’s petition to make diabetic accessories available for American Girl dolls. Little did they know that American Girl already had such a project in the works—or how happy they’d be with the results!

Juvenile Diabetes Research Foundation enlightens my Hopes…

Breaking Free from the Daily Burden

JDRF toured ViaCyte’s labs to learn about VC-01TM encapsulated cell therapy

ViaCyte opened its doors last month to a small group of JDRF volunteers and staff to tour the facility. The group learned how ViaCyte has been developing an islet replacement therapy to treat type 1 diabetes (T1D) for the last ten years. “We heard how stem cells become functioning pancreatic cells in ViaCyte’s macroencapsulated drug delivery system and how they can mature into insulin-producing beta cells offering people living with the disease an extended break from daily insulin injections and blood-glucose testing,” said Julia Greenstein, Ph.D., vice president, discovery research at JDRF. To learn more about ViaCyte’s trial of its VC-01 islet cell replacement therapy, which is contained in a semipermeable device called Encaptra®, watch this brief video.

“Twelve patients from two trial sites, one in San Diego, California and one in Alberta, Canada, have received encapsulated pancreatic progenitor cells derived from stem cell therapy. We’re now positioned on the crux of being in a clinical study with the stem cell derived islet replacement being delivered in an encapsulation system, and many consider this to be the Holy Grail of type 1 diabetes therapy,” said Kevin D’Amour, Ph.D., vice president, research and chief scientific officer at ViaCyte. Encaptra acts like a teabag, holding the cell therapy inside.

The cells are completely sealed into the device and, like tea in a teabag, cannot escape, and more importantly, immune cells cannot get inside. The device protects the implanted cells from the immune system, overcoming an obstacle that held back other encapsulation designs.

“The macroencapsulation device is implanted under the skin through an outpatient surgical procedure and the therapy is designed to last at least a year, possibly up to five years, before needing to be replaced,” Dr. D’Amour said.

As far as next steps, ViaCyte plans to use these initial results to optimize the therapy before moving to more patients. In the next phase of the trial, ViaCyte would increase the dose of cells being used and would be looking for therapeutic efficacy. “If all goes according to plan, people living with T1D get to throw away their needles and forget about the daily burdens of managing their blood sugar,” according to Dr. D’Amour.

Why It Matters:

With JDRF’s support, ViaCyte’s researchers can help more people with type 1 diabetes lead a more normal life filled with less worry and less time managing their disease. Its VC-01 islet cell replacement therapy may also offer reduction in serious chronic health conditions caused by swings in blood glucose.

By Emily Howell • JDRF

Símbolos, símbolos y Más símbolos

Este artículo específico se orienta hacia el principal símbolo de la diabetes. Como tales cosas se han vuelto siempre tan popular en este día y edad en la última década más o menos, símbolos crear conciencia y apoyo personal a las mayores tribulaciones que enfrenta la comunidad mundial. La diabetes es uno entre cientos. Como Abogado Global conciencia de la diabetes, espero para refrescar sus recuerdos en que le dice que noviembre es el Mes de Concientización Internacional de Diabetes.
“El círculo azul es el símbolo universal para la diabetes Hasta 2006, no había ningún símbolo mundial de la diabetes El propósito del símbolo es dar a la diabetes una identidad común Pretende…:

– Apoyar todos los esfuerzos existentes para aumentar la concienciación sobre la diabetes;
– Inspirar nuevas actividades, llevar la diabetes a la atención del público en general;
– Marca de la diabetes; y
– Proporcionar un medio para mostrar su apoyo a la lucha contra la diabetes.
“¿Cuál es la historia del círculo Azul?

“El icono fue desarrollado originalmente para la campaña que dio lugar a la aprobación de la Resolución de Naciones Unidas 61/225” Día Mundial de la Diabetes “.
“La campaña por una Resolución de las Naciones Unidas sobre la diabetes fue la respuesta a la pandemia de la diabetes que se establece para abrumar a los recursos sanitarios de todo el mundo. La campaña movilizó a las partes interesadas la diabetes detrás de la causa común de asegurar una Resolución de las Naciones Unidas sobre la diabetes. Las Naciones Unidas aprobó la Resolución 61 / 225 ‘Día Mundial de la Diabetes’ el 20 de diciembre de 2006.
“¿Por qué un círculo?

El círculo se repite con frecuencia en la naturaleza y por lo tanto ha sido ampliamente utilizado desde los albores de la humanidad. El significado es muy positiva. En todas las culturas, el círculo puede simbolizar la vida y la salud. Lo más significativo de la campaña, el círculo simboliza la unidad. Nuestra fuerza combinada es el elemento clave que hizo que este apoyo de una Resolución de las Naciones Unidas sobre la diabetes y tiene que permanecer unidos para hacer una diferencia. Como todos sabemos: no hacer nada no es una opción.
“¿Por qué azul?

“La frontera azul del círculo refleja el color del cielo y la bandera de las Naciones Unidas. Las Naciones Unidas es en sí mismo un símbolo de unidad entre las naciones y es la única organización que puede ser señal de que los gobiernos de todo el mundo que es el momento de luchar diabetes y revertir las tendencias mundiales que impedirán el desarrollo económico y causar tanto sufrimiento y muerte prematura.

“¿A quién pertenece el símbolo?

“La Federación Internacional de Diabetes (IDF) tiene todos los derechos sobre el círculo azul de la diabetes.”
https://en.wikipedia.org/wiki/List_of_awareness_ribbons
¡El conocimiento es poder! Apenas Sayin “… y pasando algunos junto a usted. Es importante para mí que usted sabe.
A. K. Buckroth (#buckroth)

Symbole, symbole i więcej symboli

Ten artykuł jest nastawiona na konkretne cukrzycy głównym symboli. Jako takie rzeczy TRO Ever-tak w dzisiejszych czasach Ostatnia ciągu ostatniej dekady i symboli osobistych MRE przynieść wsparcie dla cierpień, jakie stoją przed globalnym Zwiększona społeczności. Cukrzyca jest jedną spośród setek. Jako globalny Diabetes Awareness rzecznika, mam nadzieję, aby odświeżyć wspomnienia Cua wydrukować informacją, MA listopada Diabetes Awareness Month jest międzynarodowa.

“Niebieski okrąg jest uniwersalnym symbolem cukrzycy Do 2006 roku, nie było globalny symbol cukrzycy Celem symbolem jest dać cukrzycy wspólnej tożsamości Ma on na celu…: – Wspieranie wszelkich starań do już istniejących MRE do podniesienia o cukrzycy; – Inspire nowy HOAT, wprowadzają na cukrzycę do wiadomości ogółu społeczeństwa; – Cukrzyca Marka; i – Zapewnić środki ponownie, aby pokazać poparcie dla walki z cukrzycą.

“Jaka jest historia niebieskim kole?

“Ikona został pierwotnie opracowany na potrzeby kampanii spowodowało przejście MA uchwałą ONZ 61/225” Światowego Dnia Cukrzycy “.

“Kampania na rezolucję ONZ w sprawie cukrzycy było odpowiedzią pandemii cukrzycy ustawiony przerastają zasobów Nam opieki zdrowotnej na całym świecie. Kampania pozyskanego za wspólną sprawę, interesariuszy cukrzycy uchwały Narodów Zjednoczonych o Zabezpieczanie cukrzycy. Zjednoczona Narodów przeszedł Rozdzielczość 61 / 225 ‘Światowy Dzień Cukrzycy “w dniu 20 grudnia 2006 r.

“Dlaczego koło? Koło występuje często charakter druku i powszechnie stosowane, ponieważ jes được zarania ludzkości. Liczne pozytywne-znaczenie jest. W różnych kulturach, koło może symbolizować życie i zdrowie. Co najważniejsze dla kampanii, koło symbolizuje jedność. Nasze połączone siły jest kluczowym elementem, który się tego wsparcia rezolucji ONZ w sprawie cukrzycy i musi pozostać zjednoczona, aby coś zmienić. Wszyscy wiemy, jak: “nie robić nic już nie jest rozwiązaniem.

“Dlaczego niebieskie?

“Niebieska granica okręgu odzwierciedla kolor nieba i flagę Narodów Zjednoczonych. Organizacja Narodów Zjednoczonych jest symbolem jedności Itself wydrukować Wśród narodów jest jedyną organizacją i może sygnalizować rządy wszędzie Co to CO jest czas, aby walczyć cukrzycy i odwrócić światowe trendy utrudniają SE Rozwoju Gospodarczego i przyczyny, tak bardzo zatrzymany i przedwczesna śmierć.

“Kto jest właścicielem symbol?

“International Diabetes Federation (IDF) Posiada wszelkie prawa do niebieskiego okręgu cukrzycy.”

https://en.wikipedia.org/wiki/List_of_awareness_ribbons

Wiedza to potęga! Po prostu mówię “… i przekazywanie niektórych wraz z tobą. Ważne jest dla mnie, że wiesz.

A. K. Buckroth (#buckroth)

Symbols, Symbols and More Symbols

This specific article is geared toward the main diabetes symbol.  As such things have become ever-so-popular in this day and age over the last decade or so, symbols bring awareness and personal support to the increased tribulations faced by the global community.  Diabetes is one among hundreds.  As a Global Diabetes Awareness Advocate, I hope to refresh your memories in telling you that November is the International Diabetes Awareness Month. 

“The blue circle is the universal symbol for diabetes.  Until 2006, there was no global symbol for diabetes.  The purpose of the symbol is to give diabetes a common identity.  It aims to:

  • Support all existing efforts to raise awareness about diabetes;
  • Inspire new activities, bring diabetes to the attention of the general public;
  • Brand diabetes; and
  • Provide a means to show support for the fight against diabetes.

“What is the History of the blue circle?

“The icon was originally developed for the campaign that resulted in the passage of United Nations Resolution 61/225 “World Diabetes Day.”

“The campaign for a United Nations Resolution on diabetes was a response to the diabetes pandemic that is set to overwhelm healthcare resources everywhere.  The campaign mobilized diabetes stakeholders behind the common cause of securing a United Nations Resolution on diabetes. The united Nations passed Resolution 61/225 ‘World Diabetes Day’ on December 20, 2006.

“Why a circle?

The circle occurs frequently in nature and has thus been widely employed since the dawn of humankind.  The significance is overwhelmingly positive.  Across cultures, the circle can symbolize life and health.  Most significantly for the campaign, the circle symbolizes unity.  Our combined strength is the key element that made this support a United Nations Resolution on diabetes and needs to remain united to make a difference.  As we all know: to do nothing is no longer an option.

“Why blue?

“The blue border of the circle reflects the color of the sky and the flag of the United Nations.  The United Nations is in itself a symbol of unity amongst nations and is the only organization that can signal to governments everywhere that it is time to fight diabetes and reverse the global trends that will impede economic development and cause so much suffering and premature death.

“Who owns the symbol?

“The International Diabetes Federation (IDF) holds all rights to the blue circle for diabetes.”

https://en.wikipedia.org/wiki/List_of_awareness_ribbons

Knowledge is power!  Just sayin”…and passing some along to you.

A. K. Buckroth (#buckroth)

BlueCircle4Diabetes

Returning to Syringes After Insulin Pump Usage

This particular article pertains to one of many diabetes choices for self-care.  Although the choices to stay alive with this disease may seem limited, they do exist.

For example, food choices are a great factor and choice with a yes or no answer through a calculated decision; which exercise to perform on which day (constant and effervescent planning and scheduling) in order to break down calories and maintain an acceptable weight, encourage the body’s circulation, neurological and every other multitudinous life system;  maintaining a daily, constant schedule of repeat medication choices, be it insulin doses or pill forms.  I’m sure you can come up with a number of your own choices when attempting to balance this demon.

At his time in my life, I have been diabetic for more than 56 years.  Approximately twenty (20) years ago, I made the decision to purchase an insulin pump, go through the rigamorole of accomplishing this task alone, and live happily ever after.  (Buckroth, A. K.  My Diabetic Soul – An Autobiography, 2010, Prismatic Publishing, Roseville, CA, page 230).

My initial prompting to return to insulin injections is due to a second infection of an infusion site from the us of an infusion set. Although I use rubbing alcohol consistently on my body parts to do this when changing sites, rubbing the cleaned and chosen rotated area profusely, an infection occurred, again. A year ago last October (2014), an infection from a site in my left hip brought me to my GP’s (General Practitioner’s) office. It was red, swollen and pussy = infected. She took a fluid sample of the ‘wound,’ sent it to the lab, confirming E-coli. Ugh and WTH.  Placed on a 10-day antibiotic, I blamed that instance on my changing the set and site in my bathroom. I blamed me before anyone else had the chance to do so!

Use to having authority figures (doctors, nurses, medical staff personnel, etc.) blame me for any – any – wrong doing or misunderstanding of a diabetes hardship, I swallowed this one as well. I am OCD (Obsessive Compulsive Disorder) due to diabetes, meaning I am overly clean. My personal blame for this personal infraction is toward the insulin pump company. No,I did not alert them of this instance or the latest one either. “Why bother?” I asked myself.  “They” are only going to, once again, list involved variables, try to gain facts, and point to me, the user/operator.

You see, I am tired – tired of having to fight medical establishments for proper care.  Tired of one doctor sending me–referring me–to another because he or she does not know or does not want to be bothered with any one of my circumstances. Period.  Not only have I learned to take care of myself, my adult years have further encouraged such strategic and minute care through holistic, naturopathic, herbology, and ayurvedic measures through lengthy internet research.

The insulin pump has terribly scarred my body.  It has caused an increase in my white blood cell count for good reason after having an intrusive–albeit plastic needle in my person constantly–decreasing my already weakened immune system.  Twenty years is a long time for anything, never mind having to have an intrusive needle in your person day-after-day-after-day.

Although having diabetes, juvenile diabetes (T1D), has been accepted through force upon me through no choice of my own, and to me from family and friends, it continues to remain misunderstood – until an individual or a loved one are singled out by the powers that be to become a diabetic.  Through these many years, diabetes has been embarrassing, even humiliating to deal with.  It’s not easy, as with any disease.

Therefore, with all this said and done, my decision to return to insulin injections remains specifically due to the popularity of insulin pens: the needle heads are smaller, thinner, unable to intimidate nerve damage, scarring, bruising, bleeding, discomfort and infection(s).  I was brought up with injections.  Two shots a day through a glass and metal contraption (way before disposable needles) containing NPH (pig and cow insulin) for “long lasting” control and Regular insulin, “fast acting” insulin twice a day.  Returning to that necessity is my goal.

Perhaps I am reverting to my younger self, when childhood was brighter, my knowledge of self-care was new and hopeful.  However, as an older adult, I once again must confront the young doctor(s) to listen to my plea.  I have had diabetes longer than any of them have been born, never mind longer than they have been doctors!

Reality is frightening when pleading for a change as a cure is on a distant horizon.

Just sayin’.

A. K. Buckroth