Scientists have created the first “cyborg” pancreas implants to treat type 1 diabetes.
The clusters of insulin-producing “islet” cells interlaced with electronics — called “cyborg pancreatic organoids” — could be implanted into patients who are unable to produce the vital hormone needed to regulate blood sugar.
In those suffering from type 1 diabetes, the immune system destroys the pancreas’s beta cells, which make insulin. Without it, sugar builds up in the bloodstream, which can cause confusion and loss of consciousness.
Over time, persistently high blood sugar damages the eyes, kidneys, nerves and heart. Patients must monitor their blood glucose and regularly inject insulin. About 400,000 people in the UK live with the condition, according to Diabetes UK, and the number is rising.
In severe cases some patients receive transplants of donor islet cells or a whole pancreas, but organs are scarce and recipients must take drugs for life to prevent their immune systems rejecting the new organs.
For years, scientists have tried to grow replacement islet cells in the laboratory.
Starting with stem cells — which have the potential to become almost any kind of cell — they can now produce clusters that look like the real thing.
• Diabetes patients to get gadget ending need for insulin injections
The difficulty is that these lab-grown “organoids” often behave like immature versions of adult tissue. They do not reliably sense glucose or release insulin in a co-ordinated way.
The new work, published in the journal Science, attempts to overcome that hurdle.
Researchers at the University of Pennsylvania School of Medicine worked with engineers at Harvard University to combine stem-cell biology with soft electronics.
They inserted an ultrathin, flexible mesh of conductive wires — thinner than a human hair — into developing pancreatic tissue. As the cells assembled into clusters, the mesh became woven through them.
The electronics can record the faint electrical signals produced by the cells that control insulin release. They can also deliver small pulses of electricity back to the cells.
The researchers then exposed the organoids to a daily pattern of electrical stimulation, designed to mimic the body’s natural 24-hour rhythm and the surges in blood sugar that follow meals.
After several days, the cells began to behave more like mature islets. Their internal signalling shifted, neighbouring cells started working in concert and insulin release became stronger and better timed.
Juan Alvarez, who oversaw the work at Penn, said there are two ways the approach might be used.
One would be to use the electronics as a training tool: stimulate the cells in the laboratory until they mature, then transplant them without any device attached. The other would be to implant the mesh alongside the cells, allowing their activity to be monitored and adjusted inside the body.
In time, he suggests, such a system could operate automatically.
Software might monitor the cells’ signals and stimulate them when needed. “In the future, we could have a system that runs without human intervention,” he said.
More work is needed before patients can benefit. The transplanted cells still need to be protected from being attacked by the immune system.
But the study shows that carefully applied electrical signals can help lab-grown tissue develop the behaviour of a working pancreas.
Alvarez said: “The words ‘bionic’, ‘cybernetic’, ‘cyborg’ — all of those apply to the device we’ve created.
“Just like pacemakers help the heart keep rhythm, controlled electrical pulses can help pancreatic cells develop and function the way they’re supposed to.”