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Every year, 500 people in Belgium develop diabetes. Two VUB professors have made it their life’s mission to give patients new hope, and treatment prospects.

 

Text: Linda A. Thompson

 

Diabetes is a disease that develops when a type of cell known as a beta cell is destroyed by the body’s immune system, or when those beta cells fail to produce sufficient insulin. The result is that the body is no longer able to keep blood sugar levels steady. It is estimated that 500 people under the age of 40 develop diabetes in Belgium every year. The number of patients with Type 1 diabetes – the autoimmune and most severe form – has also steadily been rising in recent years.

Dr Harry Heimberg has spent the past two decades developing experimental animal models with the aim of discovering what triggers the generation of beta cells in humans. With his team at the Beta Cell Neogenesis research unit on the Brussels Health Campus in Jette, he made the milestone discovery that non-beta cells – known as facultative progenitors – can be triggered to change into beta cells.

 

The next step, Heimberg says, is to figure out who is doing what, so to speak. “We’re now looking for the signals that are needed to activate these progenitor cells in order to subsequently be able to mimic their complex micro environment in a controlled fashion in a test tube.”

 

The through line in Heimberg’s past and present research is that he and the roughly 10 other scientists on his team have never shied away from what he describes as “controversial” ideas. It’s an approach that has allowed them to make pioneering discoveries, like the existence of cell types that are able to transform into beta cells. [Continue reading below the picture]

The next step, Heimberg says, is to figure out who is doing what, so to speak. “We’re now looking for the signals that are needed to activate these progenitor cells in order to subsequently be able to mimic their complex micro environment in a controlled fashion in a test tube.”

 

The through line in Heimberg’s past and present research is that he and the roughly 10 other scientists on his team have never shied away from what he describes as “controversial” ideas. It’s an approach that has allowed them to make pioneering discoveries, like the existence of cell types that are able to transform into beta cells.

 

“Most researchers used to think that the pancreas did not have any facultative progenitor cells, but we demonstrated in our model that this was in fact the case and that they can become active through tissue damage,” he says, pointing out that researchers had been looking for evidence of such progenitor cells for years and that the conventional wisdom held that only the division of beta cells can produce new beta cells. “Partly because of the data we produced and because we did not let our thinking be limited by dogmas, a lot of other researchers started looking for other cell types from which beta cells can develop.”

 

A lot of work remains to be done and there are still a lot of questions and unknowns, Heimberg says. “But by not shying away from controversial topics, we’re trying to make a contribution to diabetes research by using animal models as creatively as possible and exploring hypotheses that others aren’t investigating or that are viewed as implausible.” [Continue reading below the picture]

Relief in sight?

Also on the Brussels Health Campus, Dr Bart Keymeulen is fighting diabetes on a different front at the Diabetes Research Center. A couple of months ago, Keymeulen premiered a novel experimental treatment at UZ Brussel. Three patients with Type 1 diabetes were given encapsulated, subcutaneous implants of embryonal stem cell-derived cells that Keymeulen and his colleagues hope will develop into beta cells that produce sufficient insulin. If successful, the treatment would offer significant advantages over the treatment currently offered to some Type 1 diabetes patients, namely beta cell transplants from donor pancreases. The hope is that at a later stage the new implant treatment can also be offered without a permanent need for anti-rejection drugs.

 

The new experimental treatment could offer Type 1 diabetes patients new hope and treatment prospects, says Keymeulen. “We’ve done a lot of research on animals and now we’ve finally arrived at the stage where we can examine the capacity of these cells in humans. Do they perform as well as the traditional donor beta cells and might they offer a better qualitative and quantitative alternative to the traditional transplant treatment? Quantitative because we can make billions of them and qualitative because we hope to prove that the cells will also perform well,” Keymeulen explains.

 

Currently, Type 1 diabetes patients depend on the availability of donor pancreases, and there are many more patients in need of beta cell transplants than there are donors. “So this might allow us to reach many more patients,” Keymeulen says. “And because donors are very variable when it comes to the quantity and quality of the beta cells, these embryonal stem cell-derived cells may represent a more trustworthy cell source.”