27 October 2006

Stem cells... "A cure is just around the corner"

There has been some shouting and finger pointing at the Michael J. Fox advertisement for embryonic stem cell research and much characterization of that ad and the faults of it. Be that as it may, other folks, suffering other conditions are dragged into this and it is said: "These people would benefit, too!!"

Being one of those people and long-time sufferer of Type 1 diabetes let me add my two cents worth in on this from what I have seen.

Ever since the discovery that not producing insulin caused diabetes there has been the saying: "A cure is *just* around the corner." And since the 1930's that has been exactly the case. Remember that when you read onwards...

Now once defined as 'juvenile diabetes' due to typical age population, Type 1 is now recognized as something that can strike any time in life and has typical schema of how it happens. Type 2 has the majority of diabetes sufferers at 90% of the diabetic population. Type 2 is a resistance of the body to its own insulin production and/or a slow metabolic decline due to overused and overstimulated insulin producing beta cells. It is generally a slow onset disease and used to strike an inverse population of the elderly, but it is also now spreading in typical age range.

Type 1 is a fast onset condition. The cause of that condition took decades to figure out and the cure was seen as the amelioration of that underlying causation. Stop the cause, stop the effect. We have come to understand that it is an autoimmune disease with uncertain trigger mechanisms: for some reason the body's immune system decides that insulin producing beta cells are not wanted and attacks them. The body does try to compensate by increasing production from remaining cells, until those, too, are taken out. The tipping point is sudden and an individual can lose 90% of their beta cells before anything is noticed because the body has much in the way of excess capacity.

So the cure must go after the immune system *and* getting cells to produce insulin back on line without being attacked. Which is why we saw all sorts of transplants from organ donors, and that actually works if one can tolerate the immunosuppressant therapy. Newer drugs are helping to address, that, too, so that the effects of the drugs are not so awful. Getting the idea of "a cure is just around the corner" here?

The treatment for Type 1 is subcutaneous injection of insulin, to be slowly absorbed by surrounding tissue into the blood stream. Insulin used to come from slaughterhouses for pigs and cattle and sheep, but that changed when the whole recombinant DNA concept put human insulin producing capability into other cells more amenable to industrial production. Insulin uptake has been slowed by using variations on the long-chain insulin molecule so that there are now very slow uptake insulins that serve to give a basal absorption rate and thus keep blood glucose levels down, and only some of the fast acting insulin for just after meals. Beta cells produce insulin in response to need on a cycle of about every 15 minutes or so. They have a feedback mechanism directly into the bloodstream and the entire body reaches homeostasis due to that mechanism. For Type 1 diabetics your conscious thought patterns ARE that feedback mechanism. All of this took decades to develop, with "a cure just around the corner"!

Now, here is one of those things that really do make you scratch your head and say: What were they thinking?

Over in the X-Ray crystallography arena there were stunning and wonderful advances in finding out that you can shoot X-Rays through crystals of any substance and get the ratios of atoms in the substance and even a good hint at what it's structure is. That is how DNA was finally figured out: trying to make the structure that would create the known diffusion pattern out of the known chemicals and their ratios. That took awhile. One of the first things to be looked at was, naturally, insulin. The actual insulin produced by your cells is *not* what is bought in the bottle. The body produces a three part molecule that comes in two long strands and one very short strand, in the form of an 'H' labeled: a, b, c. What your body does is this: a cell will take up that molecule if it is needed, snip out the 'c' portion and put the 'a' and 'b' portion together to form the long chain, active insulin molecule. Type 1 diabetics get around that with the man made stuff as it is 'ready to go' straight from the needle.

In your body this structure is, itself, one that stops the molecule from putting itself into a cell and having it use up more sugar. The uptake system for naturally made, internal insulin means that in its 'H' arrangement it is *inactive*. It is only picked up at *need*, otherwise removed naturally by your body through various means. So Type 1 diabetics have to manage the forced cellular reaction cycle to avoid sudden onset of low blood glucose levels due to too high an insulin compensation. A normal body doesn't worry about it as the molecule it makes is *inactive* until needed. That is why the beta cells take 15 minutes to recycle: they measure the blood glucose level on their own and then put out an amount and retest in 15 minutes. Too low and they do *not* add more. Too high and more is sent out.

One of the early thoughts for insulin was to use an inhaled form, as injection sites, even when well rotated, can gain scar tissue and start to have problems providing a steady uptake of insulin. But, the molecule wouldn't pass through the lung lining.... I mean that was so often stated to me as I first learned about my condition that it was taken as THE TRUTH. Everyone was looking to add enzymes to insulin and do it nasally or get it encapsulated so it could somehow be digested... everything was looked at because insulin wouldn't pass through the lung's lining.

Welcome to 2006.

Inhaled Powdered Insulin.

It is full, three part, as the body makes it, human insulin.

It is crystallized and then powdered finely.

It will pass through the lung lining.

I had to talk to my endocrinologist about this, and that is the thorough description.

It doesn't need anything, although some preservatives and dessicants to keep it from going bad are most likely added. Those will not pass through the lung lining or really do much of anything. Having had exercised induced asthma in the 1970's, I can tell you that inhalers were available at least that far back for this purpose and much further back other types could easily have been adapted to this.

Stem cells?


Why is it that 1950's era technology was NOT fully tested to ensure that powdered, crystalline insulin did NOT pass through the lung lining?

That experiment is barely a Master's Degree work. Off the shelf components. Off the shelf capability. Off the shelf everything.

An effective treatment for Type 1 and Type 2 diabetics is getting them insulin on-time and in the right amount. The body self-regulates uptake of the three-part insulin molecule so that you cannot overdose on it and it remains inactive until used. This can be done by getting crystalline insulin through the lung lining. How many decades has NO ONE LOOKED INTO THIS?

Excuse me but "A cure is just around the corner."

To this day that is still true.

Diabetes research into the underlying causes of the disease has boosted the overall scientific understanding of the entire immune system, and how it can go haywire all on its lonesome.

An effective, non-invasive treatment has been sitting on laboratory shelves for decades. Even worse, not one single biochemist or medical student saw fit to question what 'everyone knew' or at least do the necessary rigorous follow-ups to previous work to ensure that it was done properly.

Stem cells?

"A cure is just around the corner."

Sure it is.



Oh, yeah.

And I, for one, have been around the block a few times.

Make me no more promises.

For I am tired of the lies of promises unkept.

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