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 Diabetes basics: Helping you understand the science Science can get pretty technical. So, despite our best efforts, sometimes we might use terms you don’t quite understand. We’ve prepared a list of the Top 10 words and concepts that will help you grasp the exciting progress we’re making at the DRI. In addition, we answer the question what is diabetes and explain the differences between type 1 and type 2 in the Diabetes & You section of our website. 1. What are the stages of research? Basic – Establishing core concepts in the lab; experiments in Petri dishes, test tubes Pre‐clinical – Testing and assessing new therapies in well‐studied animal models Clinical – Conducting controlled clinical trials with human patients 2. What does “in vitro” and “in vivo” mean? in vitro ‐‐Research performed in a controlled environment, such as in a test tube or Petri dish, not in a living organism. In Latin, it means “within the glass.” in vivo ‐‐ Experimentation using a whole, living organism as opposed to a partial or dead organism, or an in vitro controlled environment. In Latin, it means “within the living.” 3.What are islet cells? Are they different than beta cells? Islet cells – Islets are clusters of cells in the pancreas ‐‐ the cells that produce hormones. They constitute about one to two percent of the mass of the pancreas, and are scattered throughout the organ. There are about 1 million islets in a healthy adult human pancreas. Within the islets are, among others, such cells as: • Alpha cells ‐‐ produce glucagon, a counter‐regulatory hormone to insulin; prevents hypoglycemia (low blood sugar) • Beta cells ‐‐ produce insulin and amylin, hormones key to converting blood glucose to “energy” or glycogen stored in muscles and the liver • Delta cells – produce somatostatin; inhibits the release of insulin and glucagon Beta cells – As explained in a bullet point above, beta cells are within the islets. They sense the level of sugar in the blood and, in response, produce and release precise amount of insulin. They make up 65‐80% of the cells in the islets. 4.When islet cells are transplanted, where do they come from? Where do they go? Where they come from – Human islet cells used for transplantation are harvested from a deceased donor pancreas. Scientists must isolate the islets – that is, separate them from the rest of the pancreas. The DRI and labs worldwide isolate islets by using the Ricordi Chamber, equipment invented by the DRI’s Scientific Director, Camillo Ricordi, M.D. Where they go – After isolation, islets are usually infused through a large vein into the patient’s liver. Researchers at the DRI currently are investigating alternate sites. 5.What’s a “graft”? Graft – The transplanted tissue. In the case of islet transplantation, the islet cells are the “graft.” 6.What’s an “immune attack” or “immune response”? Immune attack, immune response – When foreign tissue, such as a virus, enters your body, your immune system responds by mounting an attack, killing the unwanted “invaders.” This protects you from disease. In the case of transplants, the immune system sees transplanted tissue as foreign, leading to an immune attack and transplant rejection. 7.What does “autoimmunity” mean? Autoimmunity – This is when your immune system mistakenly sees parts of your own body as foreign ‐‐ and attacks them. In other words, the body actually attacks its own cells. Type 1 diabetes is an autoimmune disease. The immune system destroys the insulin‐producing “beta” cells in the pancreas. 8.What are immunosuppressants? Immunosuppressants ‐‐ Also known as “anti‐rejection” drugs. These drugs suppress the immune system. In the case of transplants, they’re given to the transplant recipient, so the patient’s immune system will not be strong enough to attack the transplanted “foreign” tissue. When immunosuppressants are given “systemically” – that is, they circulate throughout the entire body ‐‐ the entire immune system is suppressed. That makes the patient more susceptible to infectious diseases and cancers. 9.What does “tolerance” mean? Tolerance – In diabetes research, “tolerance” refers to “immune tolerance” ‐‐ when the immune system tolerates, or accepts foreign tissue as its own, without mounting an attack. In auto‐immune diseases, such as type 1 diabetes, tolerance can also refer to “self tolerance” or the acceptance of one’s own insulin‐producing cells. At the DRI, researchers are trying to re‐educate the immune system – trying to induce tolerance – so the body accepts the insulin‐producing beta cells without attacking them. 10. What does “differentiation” and “transdifferentiation” mean? Differentiation – When a less specialized cell becomes a more specialized cell type. As stem cells mature, they “differentiate” and become specific kinds of cells. In diabetes research, scientists are trying to push stem cells to differentiate in such a way that they become insulin‐producing beta cells. Transdifferentiation – Transdifferentiation, or Cell Reprogramming, takes place when a mature, defined cell is transformed into a different type of cell. Researchers at the DRI are developing ways to change a cell’s function ‐‐ turning cells with one job into insulin‐
producing beta cells.