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U of A, Cornell researchers team up on technology to hide transplanted islet cells from the immune system

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Diabetes researchers at the University of Alberta and Cornell University have successfully combined two innovative surgical techniques for transplanting insulin-producing cells, offering people living with diabetes hope that the life-saving treatment could one day be made safer and more widely available.

In a paper published today in the journal Nature Biomedical Engineering, the scientists report sustained cell survival and diabetes reversal in mice that received subcutaneous islet transplants from other mice, rats and humans without using harmful anti-rejection drugs.

“If we’re to move our transplant therapy forward to treat children, or to treat patients who have very stable, easy-to-control diabetes or Type 2 diabetes, we need something that’s going to cause less harm,” says James Shapiro, Canada Research Chair in Transplant Surgery and Regenerative Medicine and professor of medicine and surgical oncology at the U of A.

“If we could do a transplant with less or no anti-rejection drugs, we could do it much more safely, and we could include more patients who could benefit.”

Shapiro cautions that while the results seem promising, the method needs to be further tested in larger animals, and eventually in humans, to know its full potential.

Shapiro leads the Edmonton Protocol, which has allowed 750 transplantations of donated islet cells since it was first developed 21 years ago. Many of those patients no longer need to take insulin injections for their diabetes but they face a lifelong regime of anti-rejection drugs, which can make patients vulnerable to infection and even cancer.

Shapiro has devoted his career to perfecting the transplantation technique and making it more accessible. Though most successful islet cell transplants are currently grafted into the liver, it is not considered an ideal site because it’s hard to monitor or remove the transplanted cells from the internal organ. In 2015, Shapiro’s team created a potential alternative transplant site under the skin by placing a plastic tube in the forearm, allowing blood vessels to form around it, then removing the device, leaving behind a vascularized pocket for transplantation.

In 2017, Shapiro read about another transplantation innovation from Minglin Ma, professor of biological and environmental engineering at Cornell University, and invited him to collaborate. Ma and his team had created a removable polymer thread containing thousands of islet cells protected by a thin hydrogel coating that could be implanted into a patient’s abdomen without triggering an immune response.

“I was intrigued by the virtue of Ma’s approach as it avoided the need for immunosuppression, and I wondered if we might combine our two innovative strategies to improve cell survival,” recalls Shapiro. “And indeed it worked! By combining the two, it really did improve the skin site for engrafting cells without the need for anti-rejection drugs. The data are very compelling.”

The teams have named their new combined approach “SHEATH,” which stands for subcutaneous host-enabled alginate thread.

“It was a great idea by Dr. Shapiro to build on two separate, very strong approaches for islet transplantation,” says Braulio Marfil-Garza, who won the Governor General’s Gold Medal for his PhD research in Shapiro’s lab and is now director of pancreatic islet transplantation at Tecnológico de Monterrey. “This was the perfect synergy.”

“We are really serious about pushing this into something clinically applicable, something that’s impactful,” says Ma, whose student Long-Hai Wang, now a professor at the University of Technology and Science of China, worked with Marfil-Garza to conduct the experiments.

Marfil-Garza believes the method should also be tested for transplants of other types of hormone-producing cells for diseases such as anemia and chronic renal disease. He is establishing a brand new islet transplant program in Mexico, with plans to treat the first patient in February 2025.

Shapiro, who is a member of the Alberta Diabetes Institute, is collaborating with Ma to seek funding for more research on the SHEATH model. He also continues to search for a new source of islet cells for transplant by growing them from stem cells.

“We want to have multiple shots on goal, so we work on multiple projects in parallel,” he says. “Nine ideas out of 10 in the lab typically will fail and it’s only the one out of 10 that moves us forward to the next step. That’s just the reality of doing scientific research.”

The research was supported by the National Institutes of Health, Novo Nordisk, the Juvenile Diabetes Research Foundation, The Hartwell Foundation, the Diabetes Research Institute Foundation of Canada and others.

 

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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