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Leading scientists from selected diabetes research institutions have come together to focus on finding a cure for type 1 diabetes. Comprised of 12 medical centers spanning 10 countries, the Diabetes Research Institute (DRI) Federation is a unique global collaboration that unites research centers to concentrate solely on curing diabetes through tolerance induction, transplantation of islets and other insulin producing cells, stem cell therapies and regenerative medicine strategies.
Joining the DRI Federation to launch this international partnership are:
- DRI - University of Miami-Miami, Florida
- DRI - University of Alberta-Edmonton, Canada
- DRI - Hospital San Raffaele- Milan, Italy
- DRI - Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) Palermo, Italy
- DRI - Hospital Universitari Bellvitge-Islet Transplantation Unit (UTIP-HUB) Barcelona, Spain
- DRI - Karolinska Institutet-Stockholm, Sweden
- DRI - University of Kyoto-Kyoto, Japan
- DRI - Centre for Molecular Medicine - Umea University-Umea, Sweden
- DRI - Universidad de São Paulo-São Paulo, Brazil
- DRI - Oxford University-Oxford, England, U.K.
- DRI - Geneva, Cell Isolation and Transplantation Center at the University of Geneva, Switzerland
While scientific collaboration is not new, the size and scope of this formal alliance combined with its prioritization of cure-focused research differs from anything ever assembled in the global medical research community. Participating centers will work to accelerate diabetes research using an integrated, translational approach with the goal of bringing promising findings to patients more quickly than ever before.
Bringing researchers together
The mission of the DRI Federation is to catalyze new ideas by grouping together researchers with specific expertise that may not be represented at each of the individual centers. The DRI Federation will synergize scientific planning and research design that will maximize efficiencies of cost, time and information transfer.
“We cannot work optimally if we are still confined by the barriers of traditional academic research. The DRI Federation is a ‘Manhattan Project’-type initiative, bringing together top researchers in key scientific disciplines who can apply their respective expertise to curing this disease,” said Camillo Ricordi, M.D., scientific director of the Diabetes Research Institute at the University of Miami.
“By expanding our collaborative interactions, we can achieve our common goal in less time and make the best use of collective resources. This collaborative structure supports the institute or investigator that is most effective in one or more of the areas of research we’ve all agreed is required for islet transplantation to be truly successful and more widely available to patients.”
Improving islet transplantation
Over the last several years, advances in islet transplantation have shown the extraordinary potential of this procedure to reverse diabetes. Clinical studies have demonstrated that infusions of insulin producing islet cells can eliminate the need for insulin injections in patients with type 1 diabetes. However, long-term results indicate that after three years of receiving an islet transplant, less than half of the patients remain insulin independent.
Additional challenges posed by anti-rejection medications and their associated side effects, for one, continue to hamper the therapy’s widespread application as a standard treatment. In the January 2006 issue of Expert Opinion, DRI Federation members reported on new strategies underway to move islet transplantation to the next level.
“Further improvements are necessary to make islet transplantation a routine clinical procedure for those with diabetes. We must overcome the limitations, which include an inadequate supply of donor pancreata, varying experience of islet isolation teams at centers performing the procedure, adverse side effects of immunosuppressants, and inconsistent long term results,” said Dr. Shinichi Matsumoto of Kyoto University Hospital in Kyoto, Japan.
These improvements can only result from an integrated research effort. Dr. Camillo Ricordi and his team first published the strategic model for this integrated research approach, or “roadmap to the cure,” in the journal Transplantation in 2005. Comprised of 11 key areas of research, the strategic model forms the basis for the DRI Federation’s collaborative partnership.
Contributions from around the world
Working in the areas of “Donor Strategies” and “Pancreas Procurement,” for example, Dr. Matsumoto and his team have been working at optimizing procedures for isolating islet cells from marginal donor pancreases to help alleviate the shortage of insulin-producing cells. The “Kyoto Islet Isolation Method” utilizes the organs from deceased donors that were previously rejected for transplant use due to their poor quality. The Kyoto researchers are also exploring other techniques to increase islet supply and obtain high islet yields.
On the other end of the spectrum, Federation partners are investigating ways to eliminate the problem of scarce donor availability altogether. Along with Israel’s D-Cure, DRI scientists are attempting to convert a portion of the patient’s own liver cells into insulin producing tissue.
Like these investigators, the other Federation teams are tackling many research areas that are critical for stem cell research, regeneration of islets, and approaches to achieve donor specific tolerance, among other emerging technologies.
“We are enormously optimistic that the pan-global efforts of the DRI Federation will pay off with the ultimate cure, and we are enormously proud to be a part of that effort,” said James Shapiro, M.D., Ph.D., director of the Clinical Islet Transplant Program at the University of Alberta in Edmonton, a longtime collaborator of the DRI whose team is working on a number of the research strategy areas.
The use of the latest satellite imaging and communication technology is a key tool for the DRI Federation’s research, training and collaboration efforts. Through advances in telescience, researchers at the partnering centers can work together on specific projects in real time, as if they were in the same lab.
“We must transfer any new pertinent finding toward new treatments for patients in the fastest, most efficient and safest way possible," said Dr. Ricordi.
A history of collaboration
Scientific collaboration has long been at the core of the DRI's research philosophy -- the key to accelerating research progress.
One example is the DRI's involvement in the “Edmonton Protocol." In this landmark study, patients with type 1 diabetes were able to achieve insulin independence using a new combination of anti-rejection drugs.
(For more, click on the video of Dr. James Shapiro, below)
At Baylor College of Medicine in Houston, Texas, scientists successfully transplanted islets into patients with diabetes -- using cells that were processed at the DRI in Miami.
The DRI collaborates with other researchers through the Clinical Islet Transplantation Consortium, a network of clinical centers and a data coordinating center established in 2004 to conduct studies of islet transplantation in patients with type 1 diabetes.
In addition, the DRI fosters collaboration by:
- Creating a global, "virtual" laboratory
- Sharing protocols and standard operating procedures
- Distributing equipment to researchers worldwide
- Participating in international research projects
- Hosting international conferences and workshops
- Training scientists from centers around the world
(For more, click on the video of Dr. Per-Olof Berggren, below)
James Shapiro, M.D. Per-Olof Berggren, Ph.D.
University of Alberta Karolinska Institutet
Edmonton, Canada Stockholm, Sweden