Overview
- A team at the Medical University of South Carolina used mesenchymal stromal cells engineered to secrete alpha-1 antitrypsin and reversed new-onset Type 1 diabetes in mice by shifting immune cells toward regulatory states.
- Researchers at the University of Missouri surface-coated donor islets with thrombomodulin and CD47 so the grafts reached normal blood sugar in more than 72% of recipients and survived 120–330 days without systemic immunosuppression.
- Both studies achieved durable benefit even though the therapies were transient: the modified MSCs were cleared quickly and the proteins on islets were only surface-displayed, yet each approach reprogrammed local immune responses.
- Key mechanisms included increased regulatory T cells, more suppressive myeloid cells and M2 macrophages, and reduced active CD8+ T cells and inflammatory innate cells that normally destroy insulin-producing cells.
- Teams say human testing is the next step but caution that safety, scale-up, donor islet supply and regulatory proof of durable efficacy remain to be solved before these approaches could reduce lifelong insulin use or chronic immunosuppression.