I know Ray and James very well. Ray is retired but I collaborated with James and colleagues at the University of Alberta. We're quite interested in this question. I think it's just not as promising as the potentially curative therapy that islet transplantation is. It's really been limited worldwide to only a few hundred patients, and that's for a number of reasons. One is that there are just not enough donor pancreases to go around, but there are also issues around how long the transplants last. Also, the recipients still have to go on immunosuppressive drugs for life to prevent the rejection of the transplant itself.
The real promise here is that when someone with diabetes injects insulin, they're making an educated guess as to how much insulin they need and they risk low blood sugars. When you put the beta cells back, the islets back, those cells know precisely how much insulin to secrete to produce them. The blood sugar control is much better and they don't have these really dangerous lows.
Going forward, I think there's great promise in stem cells as a potential source, an unlimited source of insulin-producing cells. There's world-leading research going on across the country. There's some in Vancouver, where Tim Kieffer is making these cells in the dish, and in Alberta, I know that Dr. Shapiro is doing clinical trials with these cells in collaboration with a company in the U.S.
It's not ready for prime time yet but it is important. I think the limitations here have to do with making good cells, cells that are safe and suitable for transplant, and also protecting them from the immune system. I think the research going forward is going to be finding ways to either encapsulate them or to genetically engineer them so that they're camouflaged from the immune system. We'd like to do this in a way that if it's truly curative then patients who receive the cells wouldn't need to take immunosuppressive drugs for life.