Ray Rajotte, James Shapiro: Focused on curing Type 1 diabetes

This article was originally written and submitted as part of a Canada 150 Project, the Innovation Storybook, to crowdsource stories of Canadian innovation with partners across Canada. The content has since been migrated to Ingenium’s Channel, a digital hub featuring curated content related to science, technology and innovation.

Ray Rajotte & James Shapiro: Paving the road for a cure for Type 1 diabetes

Canadian researchers have always been at the forefront of diabetes research, starting with insulin’s discovery in 1921. The next giant leap forward was the Edmonton Protocol in 1999—a major breakthrough towards a cure for the 2 million+ Canadians, and 30 million globally, Type 1 diabetics. The disease stops the pancreas producing insulin, an important hormone that helps you get energy from food. Insulin injections help Type 1 diabetics stay alive, but it’s not cure. Nor does it always prevent serious side-effects (e.g., kidney failure, blindness, nerve damage, heart attack, stroke, amputations). Diabetics have a higher risk of kidney failure, blindness, nerve damage and blood vessel disease than non-diabetics, and a reduced life expectancy.

30 years in the making
The Edmonton Protocol transplants islets cells from a healthy donor pancreas into a diabetic patient. Anti-rejection drugs then help the body accept the transplant. The procedure stems from research begun in 1972 by Ray Rajotte at the University of Alberta (UAlberta). Like many health advances, success didn’t come easily or quickly—Rajotte and his team researched and refined islet cell transplantation for almost 30 years!

1982: Canada’s 1st islet transplant
In 1982, UAlberta’s Islet Transplantation Group was created (Ray Rajotte, Edmond Ryan, Norman Kneteman and Garth Warnock). The team spent 7 years perfecting the islet isolation procedure and in 1989 performed Canada`s first islet transplant. While encouraging there were still many hurdles; hurdles the team tackled over the following next 10 years. The team also expanded adding Greg Korbutt, Jonathan Lakey and transplant surgeon James Shapiro.

1999: The Edmonton protocol
On March 11, 1999, Bryon Best became the first Edmonton Protocol recipient—within a week he no longer needed insulin injections. While not a cure, the protocol was a giant leap forward; saving lives and giving doctors a new way to combat type 1 diabetes. Recipients lead improved lives; many no longer having to depend on daily insulin injections. The procedure is now performed around the world. But, widespread adoption is limited by the shortage of donor tissue—human donation doesn’t provide enough to meet the demand. A further complication is the strong anti-rejection drugs needed to prevent transplant rejection.

Alberta Diabetes Institute
In 2007, Rajotte help found Canada’s largest freestanding diabetes research facility—the Alberta Diabetes Institute at UAlberta. The Institute’s 60+ lead scientists focus on all aspects of diabetes treatment, including nutrition, physical activity, lifestyle and surgical techniques in some of Canada’s most advanced research facilities.

What’s next
Successful islet cell extraction remains difficult—it’s challenging for researchers to determine which cells are likely to survive transplantation. Researchers are also seeking a way to combat transplant rejection. Rajotte is now working to develop an unlimited source of islet tissue and a way to overcome the need for continuous anti-rejection drugs. Shapiro, a surgery, medicine and surgical oncology professor and director of UAlberta’s Clinical Islet Transplant Program and Living Donor Liver Transplant Program, is focused on improving long-term survival of transplanted islets and adjusting the immune response of transplanted tissues to a desired level.

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University of Alberta

The University of Alberta in Edmonton is one of Canada’s top teaching and research universities, with an international reputation for excellence across the humanities, sciences, creative arts, business, engineering and health sciences.