Gene Mapping May Speed Diabetes Treatment
Genetic mutations are involved in a least 1500 human diseases, many of them major killers of large parts of the population. How mutations lead to these diseases is not well understood, but the connection between mutation and disease will be clearer and more treatable now that the human genome has been mapped.
One of the diseases that will be better treated with information from genetic sequencing and mapping is, of course, diabetes. Projections are that medical treatments will be customized for individuals, drugs will be developed that interfere only with the particular type of diabetes and particular complications, leaving the rest of the body alone. We may also see an analysis done at birth for the diseases an individual is at risk for developing and how they can be prevented.
Some caution is warranted, however. Genetic findings are not the only answer in the causes or treatments for disease. In most cases in which a mutated gene is involved, an ``environmental insult'' is needed to trigger the predisposition toward the disease. In various types of diabetes, a virus, a toxin, obesity and a lack of exercise may play a role.
Two separate efforts -- public and corporate -- have primarily explored the human genome. The recent findings, published in the February issues of Science and Nature, report that the genome contains only a third to half as many genes as expected, but that humans are very complex in the way those genes interact.
  
Engineered Skin May Heal Foot Ulcers
One of the more painful and serious complications of diabetes is that of diabetic foot ulcers, which are very slow to heal. If not treated properly, amputation might be necessary. A new treatment may eliminate the need for such drastic measures.
The treatment is called Dermagraft, and was presented by researchers at the Foot and Ankle Institute of South Florida in South Miami at the annual meeting of the American College of Foot and Ankle Surgeons, held in New Orleans (February 9, 2001). Dermagraft is made by growing the cells from infant foreskins on an absorbent mesh to create a tissue. It is then frozen, and thawed in hot water when ready to be used. Doctors then place it over the ulcer and cover it with a bandage and moist dressing.
In an on-going study, 28 participants with diabetic food ulcers were divided into two groups. Half were treated with Dermagraft, and half were treated with bandages alone. After twelve weeks, 71% of chronic ulcers in people treated with Dermagraft were healed, while only 14% of those treated with just bandages were healed. In addition, the percentage of the wound area that healed was twice as large when treated with Dermagraft, and the healing occurred much faster as well. Infections were also less common with the engineered tissue.
Although the tissue has not yet been approved by the FDA, studies continue, and the manufacturers hope that their product will soon be available to those with diabetic foot ulcers.
Organ Transplants From Animals Far Off
Only 3,000 pancreases are available for transplant each year and this number is not expected to rise. With two whole pancreases needed to perform one islet cell transplant, only 1,500 people can be offered this procedure each year, while several hundred thousand new cases of diabetes are diagnosed each year in the U.S. alone. A worldwide need for donor organs and a continued shortage of such organs has led scientists to study the possibility of transplanting animal organs into humans. A recent report indicates that this is not something that can occur in the near future.
The report was published on February 5, 2001 by the Department of Health based on information from the UK Xenotransplantation Regulatory Authority. It states that there is still not enough research on the genetic modification of the donor animals so that the gene responsible for organ rejection can be deactivated. In addition, it is still unknown whether or not animal organs can sustain human life. The overall problem is that not enough research has been conducted to have animal organ transplantation into humans occur in the foreseeable future.
Type 2 May Be Due To Fat Cell Defect
Mechanisms for the development of Type 2 diabetes are not fully understood, but a recent study suggests that the problem may be rooted in a defect in fat cells.
The report was written by scientists at Harvard Medical School , who published their work in the journal Nature (volume 409; pages 672-673, 729-733; February 8, 2001). The scientists conducted their research in mice by disabling a protein just within fat cells in the mice that is needed to transport glucose into cells. Over time, cells in the liver and muscles also started to ignore insulin, and the mice became insulin-resistant. Some mice developed high blood glucose levels, and appeared to be developing diabetes.
This study seems to support the idea that fat cells have the ability to communicate with other body organs, such as muscle and fat. More research is needed to determine how the fat cells communicate, and to see if this communication problem contributes to the development of Type 2 diabetes.
Obesity Drug Famoxin Under Development
The French biotechnology firm Genset has recently announced the positive results of its anti-obesity drug Famoxin in studies involving mice, giving hope to those who are obese and at risk for Type 2 diabetes.
The drug company described the results of their study in the on-line edition of the Proceedings of the National Academy of Sciences. Famoxin is a protein, and the drug manufacturers say that it burns fat in a similar way that insulin converts sugar into energy the body can use. Over a period of two weeks of treatment with Famoxin, obese mice lost 8% of their body weight without undergoing a change in diet.
Clinical human trials of the drug will begin at the end of 2001, but it will probably take years of research before Famoxin would be able to be introduced to the market, and it is also not clear whether humans will react as positively to this medication.
Company Earns US Patent
The Israeli biotechnology group Keryx Biopharmaceuticals has announced that it has earned a US patent on the scientific information that describes the specificity of chemicals in the body called kinases. The patent is owned by Children's Hospital of Boston and Jerusalem's Hebrew University, and is now licensed exclusively to Keryx.
Keryx is now focused on finding drugs that target kinases, which are chemicals that are of vital importance in cell communication. During the first half of 2001, Keryx will begin Phase III trials on KRX 101, which is designed to treat kidney damage caused by diabetes. Phase III trials are the last step in obtaining FDA approval for drug marketing.
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