March 19, 2009
CHARLESTON -- The Medical University of South Carolina (MUSC) is the first center in South Carolina to perform an autologous islet cell transplant for chronic pancreatitis. The patient, a woman from Aiken, had insulin-producing islet cells removed from her pancreas and transplanted into her liver.
This breakthrough procedure is the first in a series of innovative new therapies from the new Center for Cellular Therapy (CCT), a collaboration between MUSC's Hollings Cancer Center, Department of Surgery, General Clinical Research Center, the Medical University Hospital Digestive Disease Center, and Department of Pediatrics.
"The important work going on in this new Center will include advanced cellular transplants for patients with pancreatitis as well as cancer vaccine clinical trials," said Andrew S. Kraft, MD, director of the Hollings Cancer Center. "One of the most difficult steps in translational cancer research is moving a therapeutic strategy from the lab into human clinical use in a structured and safe manner. Having this facility will greatly speed up the testing of state-of-the-art cancer treatments."
MUSC's Hollings Cancer Center recently received designation from the National Cancer Institute as one of the nation's top cancer research centers. It is the only cancer center in South Carolina - and one of only 64 in the country - to hold this distinction.
The CCT, the only center of its kind in South Carolina, features a sterile facility called a clean lab where researchers produce clinical grade cellular and tissue products for patient treatment. This allows MUSC researchers to process anything from stems cells to whole organs with the goal of fighting diseases such as cancer and diabetes.
Innovative Cellular Transplantation to Treat Chronic Pancreatitis
Patients with pancreatitis suffer from numerous medical complications and severe pain. When medication is no longer effective, patients often require surgery to remove part or all of the pancreas. However, removal of the pancreas also removes the ability to produce insulin. Patients are left with no glucose control and develop Type 1 diabetes.
Last week the team achieved a major breakthrough with the first autologous transplant of islet cells. In this procedure, the inflamed pancreas is removed in the OR and taken to the "clean" laboratory, where specially trained technicians, working under a microscope, extract insulin-producing islet cells. Then an interventional radiologist used ultrasound to guide placement of a catheter through the patient's upper abdomen and into the main blood vessel in the liver. The islet cells are infused back into the liver, where they are expected to lodge in blood vessels in the liver and begin functioning like a miniaturized pancreas, producing and releasing insulin.
By extracting the islet cells from the patient's pancreas and infusing back into the liver, the hope is they will start producing insulin again to ease the diabetes symptoms that results from the removal of the pancreas.
"When patients are not treated properly for pancreatitis, they suffer from debilitating, intractable pain," said Katherine Morgan, MD, Medical Director of the Islet Cell Transplant Program . "This lab allows us to offer our patients more complete surgical therapy, such as islet autotransplantation, for pancreatitis while preventing, or at least minimizing, the potential for diabetes."
David J. Cole, MD, Chair of MUSC's Department of Surgery, and the CCT Medical Director said "In this procedure, the inflamed pancreas is required to be removed surgically to definitively address the patients disease, but the great part is that the patient's own insulin-producing islets can be salvaged by extracting and purifying them for injection into the patient's liver where they can thrive and perform their normal function". "Patients undergoing this type of transplant experience significant relief from pain and do not need immunosuppressant drugs given the fact that they are receiving their own tissue," Cole said. "Combining this facility with our surgical and research expertise will mean great gains for patients dealing with a very difficult disease.
Advancing Immunotherapy with Cancer Vaccine Clinical Trials
Historically, cancer treatment has relied primarily on surgery, radiation and/or chemotherapy. However, in the last decade scientists have realized that cancer occurs because a patient's immune system fails to recognize cancer cells as foreign and does not attack them as it would bacteria, for example. "Using the body's ability to defend against disease and heal itself is an exciting frontier in treatment and research for many diseases, said Michael Nishimura, PhD, CCT Scientific Director and Leader of the Hollings Cancer Centers Immunology Program. "In this lab we are, in essence, equipping a patient's immune cells how to recognize and destroy cancer cells. We'll be developing vaccines and other kinds of cellular therapies to use now against various kinds of cancer."
Nishimura said the CCT is already running two FDA-approved trials - one designed to prevent Type 1 diabetes in patients who had a pancreatectomy and another designed to develop a therapeutic cancer vaccine for patients with colon cancer. There are other trials in the horizon including breast cancer and pancreas cancer vaccines as well as T cell therapies for patients with melanoma and liver cancer.
More than $3.5 million dollars has been provided to create the CCT by the Hollings Cancer Center, the Medical University Hospital, the General Clinical Research Center, and the Department of Surgery. Additionally, the clean cell facility from which the CCT was created was initially made possible with a $1 million gift from the Abney Foundation to treat juvenile diabetes via allogenic islet cell transplants.
"Our Board of Directors originally saw this center as an opportunity to help end diabetes, a disease that affects almost 250 million people in South Carolina and around the world," said Carl Edwards, Executive Director of The Abney Foundation. "We've since learned that its potential impact is even broader than that, and that it could one day lead to a cure for cancer. In terms of health care benefits, the potential return on our investment in this facility is huge, and we are proud to have helped make it a reality."
Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 10,000 employees, including 1,300 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.3 billion. MUSC operates a 600-bed medical center, which includes a nationally recognized Children's Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit www.musc.edu or www.muschealth.com.