Breakthrough for diabetics banned in NZ

By SIMON COLLINS Science Reporter

A New Zealand medical research company claims an international breakthrough in diabetes treatment, but it is not permitted to use the technique here.

The Auckland company, Diatranz, says a Mexican schoolgirl given insulin-producing cells from the pancreas of newborn piglets has overcome diabetes.

It says the successful trial could eventually provide a cure for 11,000 New Zealanders and 15 million people around the world with type 1 diabetes who now need daily injections of insulin.

But the New Zealand Health Ministry has banned the process here.

Submissions close on Friday on a new law that would extend the ban until at least June 2003 and possibly two more years because of a risk that pig viruses could spread into people.

Diatranz's medical director, Dr Bob Elliott, said the girl, who is now 18, was "naturally very pleased".

"She's a young, very attractive Mexican girl, who is very relieved indeed."

Twelve teenage diabetics - six girls and six boys - received the pig cell transplants 14 to 20 months ago.

Four of the girls and one boy now produce enough of their own insulin, using the transplanted cells, to at least halve the daily injections of insulin keeping them alive.

Dr Elliott said even halving insulin injections made the transplants worthwhile because of the risks and costs of total dependence on injections.

"Diabetics currently tend to get too much or too little insulin, even in the same day. It's impossible to get the right dose at the right time because people vary in size, activity and diet.

"Their lifespan is shortened by a third because they get rather nasty blood-vessel complications. Normally the last 10 years of their lives are pretty miserable."

The transplanted cells from the pig pancreas regulate their insulin production in line with what they are eating, just like the pancreas in non-diabetics.

All human beings need insulin to break down food into a form that can be absorbed by the body.

Daily insulin injections are costly - $12,500 a year for a standard type 1 diabetic, the kind who often need injections from childhood.

By comparison, extracting insulin-producing cells from piglets, flying them to Mexico and transplanting them into diabetic patients costs only $20,000 to $25,000, saving many times that amount over a patient's lifetime.

Dr Elliott and other Diatranz scientists have made 12 trips to Mexico carrying the pig cells in their hand luggage to get them there quickly.

At the Mexico City Children's Hospital, Dr Rafael Valdes developed a unique method of transplanting the cells. He inserted a cigarette-sized stainless steel tube on each side of the stomach just under the patient's skin. At first, the tubes contained just a plastic rod.

After two months, the rod was removed and the insulin-producing piglet cells replaced it. It then took up to a year for the piglet cells to mature and start producing full quantities of insulin.

The process began with killing newborn piglets to extract their pancreas. But Dr Elliott said any animal rights objection would be "hard to square up with ham".

The procedure does not involve genetic modification - in contrast to most insulin which was originally also taken from pigs but is now made in laboratories through genetic manipulation.

Diatranz and Dr Valdes plan a further trial starting within two months to improve their success rate.

The company will then seek financing, possibly from a pharmaceutical company or a big institute such as America's Mayo Clinic, to do full clinical trials in the United States.

Dr Elliott said Diatranz had spent $7 million to $8 million so far and would probably recover its money by licensing the rights to the procedure and teaching other people to do it.

The company is owned privately by individual shareholders, most of whom have close relatives with diabetes. The biggest single investor is Warehouse founder Stephen Tindall, who became involved when he had a diabetic dog treated by Diatranz.

National Party associate health spokesman Dr Paul Hutchison said the ban on animal/human transplants should be lifted because many medical advances, such as immunisation, had involved similar risks.

"We should be doing everything we possibly can to ensure that, in an informed, intelligent way, we allow research to continue."

However, a 12-year-old diabetes sufferer who starts at Long Bay College this week, Natalie Antill, said she was glad not to have been the first to get the pig cell transplants.

"I wouldn't really want to get diseases and stuff from the pigs."

Though she did not want to be the first with a transplant, she said: "After some other people have had it done, and if it has been successful, then yes, I would."

Green Party co-leader Jeanette Fitzsimons said there was a risk that transplanting animal cells into people could transmit viruses in the same way that influenza originally spread from animals.

"It's a question of whether you can put the whole human population at risk in order to treat some individuals. It's a difficult ethical question."

She supported the Government's plan to refer the issue to the proposed Bioethics Council, a body recommended by the royal commission and due to be established this year.

A spokesman for Environment Minister Marian Hobbs, who introduced the proposed law, said the transplant clause was a matter for Health Minister Annette King.

A spokesman for Mrs King referred inquiries to the Ministry of Health, which declined to comment because the bill was before a select committee.

The transplant ban is among late changes to the Hazardous Substances and New Organisms Act, tabled on December 19.

The proposals are on the Ministry for the Environment website.

nzherald.co.nz/health