DIABETES: Tissue, Antibody Combination ‘Cures’ Monkeys

      Scientists announced yesterday the successful suppression of diabetes in seven monkeys treated with a "strikingly different" therapeutic combination: transplants of insulin-producing islet cells accompanied by "an experimental drug that prevent[s] rejection of the donor tissue." The New York Times reports that the drug, anti-CD154, is an artificial antibody that prevents tissue rejection without dangerously weakening the body's immune system -- as evidenced in the monkeys' normal growth over time and lack of infection. To date, some 300 people have received tissue transplants of pancreas islet cells, "with limited success." Thousands more have received entire pancreas transplants. The problem with both types of transplants is that "each recipient would have to take a combination of powerful anti-rejection drugs for the rest of his life." Not so in the case of anti-CD154. The cure appears to be lasting: Monthly injections of the tissue-drug combination were terminated in three monkeys after one year, and all three "no longer require injections of insulin or anti-CD154." The findings are "a major reason for cautious optimism," said Dr. Camillo Ricordi, a co-author of the report, which will be presented this year in the Proceedings of the National Academy of Sciences. Ethics committees and the FDA have approved human tests of anti- CD154, produced by Cambridge, Massachusetts-based Biogen. The NIH-sponsored trials are expected to begin soon (Altman, 6/3).