Preliminary results from an ongoing clinical trial at the University of Chicago Medicine indicate that the investigational antibody drug tegoprubart may enhance outcomes for a select group of patients with 'brittle' type 1 diabetes undergoing islet transplantation. The trial focuses on preventing the rejection of transplanted islet cells, which are crucial for insulin production and blood sugar regulation.
Islet Transplantation and the Challenge of Rejection
Islet transplantation involves a minimally invasive procedure where insulin-producing cells (islets) from a healthy pancreas are infused into a diabetic patient's liver. Once successfully transplanted, these cells can naturally regulate blood sugar levels. Currently, this treatment remains experimental in the U.S., with UChicago Medicine being one of the few centers offering it through clinical trials.
Traditional immunosuppressive drugs, while necessary to prevent transplant rejection, can damage islet cells and cause significant side effects, including kidney damage, hypertension, and even new-onset diabetes. "We’ve spent decades seeking alternatives that will prevent rejection without these adverse effects," said Piotr Witkowski, MD, PhD, director of the pancreatic and islet transplant program at UChicago Medicine.
Tegoprubart's Impact on Islet Engraftment
In the recent trial, three patients with type 1 diabetes received islet transplants in conjunction with tegoprubart. Encouragingly, two of the participants achieved normal, stable blood sugar levels, eliminating their need for insulin injections. The third participant experienced a reduction in insulin use of over 60% within days of the transplant and is expected to discontinue insulin use in the future. Researchers estimate that islet engraftment in patients treated with tegoprubart was three to five times higher than in those receiving standard immunosuppression. Notably, no unexpected adverse events were reported.
Potential for Broader Application
"Our hope is that these findings will eventually pave the way for wider adoption of islet transplantation as a standard therapy for brittle type 1 diabetes," Witkowski stated. "If we successfully validate an immunosuppressive regimen that is both safe and effective, it will allow more patients to benefit from this potentially life-changing procedure in the future."
