02 / March / 2017
“A visionary Approach to Diabetes ”
By: Abdullah Alhasan ( a 4th year medical student )
Professor Doctor Stefano Marini (Professor of Chemistry and Coordinator of English Medicine program) started the seminar and gave an introduction. He said:“By combining and interacting between scientific research and clinical activities will hopefully give astonishing results in the future”. (on the right of the photo)
Professor Doctor Davide Laure (A physician at policlinic of Tor Vergata and Full Professor of Endocrinology in the medical school) introduced the academic highlights of Professor Berggren. He said that professor Berggren is the director of Rolf Luft Research Centre of Diabetes and Endocrinology at Karolinska institute in Stockholm (Sweden). He is a member of Noble Prize Assembly (for Medicine) and the Royal Swedish Society. He has many appointments in all over the world including: Miller School of Medicine, Imperial College of London, Seoul National University and Nanyang Technological University. He had published more than 400 articles in many important journals. Dr. Berggren’s research primarily focuses on the changes of signal transduction mechanisms of Pancreatic Islets after transplantation. Collaboration between Rome Medical School (Tor Vergata) and Professor Berggren started in 2015. In 2016, he was officially appointed as “Honorary Distinguished Professor “ in Tor Vergata Medical School .
Professor Giuseppe Novelli (Full Professor of Genetics and the Rector of the University) resumed the seminar by presenting Rome University (Tor vergata). He said that it is a very young and dynamic university which is investing in the 17 sustainability goals of UN.More ever,he said that Tor Vergata University has another important goal which is“Internalisation”, by teaching and offering many courses done entirely in English in faculties of Economy, Medicine, Pharmacy (Double degree program with Nottingham University) , Humanities and Engineering. University of Rome (Tor Vergata) has signed many International bilateral agreements with many universities from all over the world including: Harvard, Oxford and Gorge Washington. International Foreign students in the university are representing 8% of total students from over 120 countries (Which is from the highest percents in Italy). Rome University Campus is extended in an area of about 600 Hectares. The university has a very important museum where students are visiting it from all over Italy. University of Rome is hosting many sports clubs and centres, of them: sailing and golf centres.
Professor Berggren has been working with Professor David Laure in their common interest of Diabetes. He was taking about what research there were doing related to pancreatic islets, trying to understand Insulin-producing cells (Pancreatic Beta Cell). He said that Pancreas is made of millions of small islets and each one is representing a micro organ .
He has been trying to understand how cells are working in the paracrine mechanism. He also said that there were 2 main challenges facing him while doing his research in Miami (From 2013 till now) which are studying the islets interactions both longitudinally and non-invasively. In his research, he was using anterior chamber of the eye to transplant islets into the iris to observe islets longitudinally and non-invasively by Fluorescent Markers. In the experiment of islets transplantation into the eye of a mice, they noticed that the full vascularisation was almost completed by 28 days and very rich innervations were developed by 30 days. This was shown by a very nice and accurate 3D photo.”The big question was: are Beta cells functioning ?” Professor Berggren said. He answered that it appears that for a few months (considerable amount of time) hyperglycaemia stopped and when they have removed the islets, it came back again.“We can consider this a metabolic transplantation” He said .
Prof. Berggren underlined the advantage of transplantation within the eye as it is an immunologically-privileged site. However, when transplantation was performed between two non-immunocompatible species, hyperglycaemia reoccurred after 14 days and transplanted Pancreatic Islets were destroyed due to immune system attack. Three different T-cells are involved in this immune reaction: Round, Elongated and Ruffle. Although Elongated T-cell moves more extensively, Ruffle T-cell engages the most in the process of killing Pancreatic Islets. A single Ruffle T-cell is able to kill 72 Beta cell within 48 hours, without the need of being attached for an extended period. (photo)
Architecture of isles of humans, rats, monkeys and pigs have been studied. Similarities and differences between islets in these species were studied as well. Islets in both humans and monkeys are almost identical and they have a very similar innervation pattern. One of the differences between islets in humans and mouses is that in humans there are “Alpha cells“ which are releasing Acetylcholine and stimulating Beta cells to secrete Insulin.
In a Lab in Singapore, Researches were done by using monkeys, this time , to transplant Pancreatic islets into their eyelids. Research was challenging because they had to design specific microscopes as they were not available in the market (As the case was in mice). Researchers said that full vascularisation was noticed after 30 days without any effects regarding blood velocity in the animals who participated. Professor Berggren showed the attendants very clear videos of vessels. It was noticeable that there was a shunt of blood from an area to another where cells need transporters or signals and actually where activities are needed. These transplantations couldn’t be done within the liver because of Immunosuppression. A study published in 2012 (Regarding islet transplantation in monkeys) showed that glycemia went down and haemoglobin A1C went down. Islets were working and no difference could be detected between the transplanted eye and the normal with any measures that ophthalmologists use.
After doing all this great job, clinical trials were done on a human patient finally and studies are mainly focusing currently on safety and not in the treatment of Diabetes. An experiment was done legally for a blind patient with a transplanted kidney (Therefore immunosuppressive drugs are already prescribed) in Switzerland. About 40 , 000 islets came down to iris (By gravity) and stick there after transplantation operation was done. One of the suggestions regarding the development of such experiment was to replace the microscope with a microscope within the eye(Advanced microelectronics).
After the seminar, there was a Q&A session with Prof. Berggren. One of the questions asked was:”How long would transplantation’s effects last, before the transplanted Islets cannot work anymore or need to be fixed?”.Prof. Berggren replied:“For many years, and probably forever!”
Last Advice from Professor Berggren for students and young researchers was to improve and enrich their curiosity because it is the essential value and wide base for research .