New device shows promise in Type 2 diabetes treatment

Researchers have found that a newly tested medical device, called ‘Sleeveballoon’, mimics the effects of traditional bariatric surgery in rodents and produces impressive results on body weight, fatty liver and diabetes control.

Sleeveballoon is a device that combines a balloon with a connected sleeve, which covers the initial parts of the small intestine. It is inserted into the stomach and bowel during minimally invasive surgery under general anaesthetic.

For the study, researchers compared the effects of the Sleeveballoon and traditional bariatric surgery on 30 rodents fed with a high-fat diet, achieving very similar results.

Results were also compared to rats, with the new device reducing food intake by 60 per cent and resulting in a 57 per cent reduction in fat mass.

The effect on diabetes was similarly impressive with blood glucose levels dropping by 65 per cent.

“Gastric bypass surgery is a highly effective treatment of obesity and type 2 diabetes. However, very few eligible patients, only around one per cent, are offered surgery and some also prefer less invasive approaches,” said study’s lead author.

“However, while gastric bypass causes a rapid rise in post food blood glucose levels which can cause hypoglycaemia, the Sleeveballoon induces a slowing down of digestion which has a steadying effect on blood sugar levels,” the author said.

“This helps control appetite and hunger, keeping the person fuller for longer and substantially reduces weight,” he added.


During the study, the research team found that the metabolic effects of the Sleeveballoon device are similar to those of the gastric bypass but have distinct advantages over the traditional method.
In both, insulin sensitivity and heart functions improved.

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 A team of US nephrologists is developing first-of-its kind implantable artificial kidney with microchip filters and living kidney cells that will be powered by a patient's own heart to help kidney patients.

Dr William H. Fissell IV, nephrologist and associate professor of medicine from Tennessee-based Vanderbilt University, is making major progress on a first-of-its kind device to free kidney patients from dialysis.

"We are creating a bio-hybrid device that can mimic a kidney to remove enough waste products, salt and water to keep a patient off dialysis," Fissell said.

The goal is to make it small enough, roughly the size of a soda can, to be implanted inside a patient's body.

The key to the device is a microchip. "It's called silicon nanotechnology. It uses the same processes that were developed by the microelectronics industry for computers," Fissell explained.

The chips are affordable, precise and make ideal filters.

Fissell and his team are designing each pore in the filter one by one based on what they want that pore to do. Each device will hold roughly fifteen microchips layered on top of each other.

But the microchips have another essential role beyond filtering. "They're also the scaffold in which living kidney cells will rest," said Fissell.

Fissell and his team use live kidney cells that will grow on and around the microchip filters. The goal is for these cells to mimic the natural actions of the kidney.

Because this bio-hybrid device sits out of reach from the body's immune response, it is protected from rejection.

"The issue is not one of immune compliance, of matching, like it is with an organ transplant," said Fissell.

The device operates naturally with a patient's blood flow.

Synthetic platelets could save lives

Researchers have created nanoparticles that mimic blood platelets. The artificial platelets could accelerate the healing process and can also be used for targeted therapies

Stanching the free flow of blood from an injury remains a holy grail of clinical medicine. Controlling blood flow is a primary concern and first line of defense for patients and medical staff in many situations, from traumatic injury to illness to surgery. If control is not established within the first few minutes of a hemorrhage, further treatment and healing are impossible.

At University of California Santa Barbara, researchers have turned to the human body's own mechanisms for inspiration in dealing with the necessary and complicated process of coagulation. By creating nanoparticles that mimic the shape, flexibility and surface biology of the body's own platelets, they are able to accelerate natural healing processes while opening the door to therapies and treatments that can be customised to specific patient needs.

"This is a significant milestone in the development of synthetic platelets, as well as in targeted drug delivery," said Samir Mitragotri, who specialises in targeted therapy technologies. Results appear in the journal ACS Nano.

HOW COAGULATION WORKS

The process of coagulation is familiar to anyone who has suffered even the most minor of injuries. Blood rushes to the site of the injury, and within minutes the flow stops as a plug forms at the site. The tissue beneath and around the plug works to knit itself back together and eventually the plug disappears.

But what we don't see is the coagulation cascade, the series of signals and other factors that promote the clotting of blood and enable the transition between a free-flowing fluid at the site and a viscous substance that brings healing factors to the injury. Coagulation is actually a choreography of various substances, among the most important of which are platelets, the blood component that accumulates at the site of the wound to form the initial plug.

"While these platelets flow in our blood, they're relatively inert," said graduate student researcher Aaron Anselmo, lead author of the paper. As soon as an injury occurs, however, the platelets, because of the physics of their shape and their response to chemical stimuli, move from the main flow to the side of the blood vessel wall and congregate, binding to the site of the injury and to each other. As they do so, the platelets release chemicals that "call" other platelets, eventually plugging the wound.

PLATELET-LIKE NANOPARTICLES

But what happens when the injury is too severe, or the patient is on anti-coagulation medication, or is otherwise impaired in his or her ability to form a clot, even for a modest or minor injury?

That's where platelet-like nanoparticles (PLNs) come in. These tiny, platelet- shaped particles that behave just like their human counterparts can be added to the blood flow to supply or augment the patient's own natural platelet supply, stemming the flow of blood and initiating the healing process, while allowing physicians and other caregivers to begin or continue the necessary treatment. Emergency situations can be brought under control faster, injuries can heal more quickly and patients can recover with fewer complications.

"We were actually able to render a 65 per cent decrease in bleeding time compared to no treatment," said Anselmo.

According to Mitragotri, the key lies in the PLNs' mimicry of the real thing. By imitating the shape and flexibility of natural platelets, PLNs can also flow to the injury site and congregate there. With surfaces functionalised with the same biochemical motifs found in their human counterparts, these PLNs also can summon other platelets to the site and bind to them, increasing the chances of forming the plug. In addition these platelets are made to dissolve into the blood after their usefulness has run out minimising complications.

These synthetic platelets also let the researchers improve on nature. According to Anselmo's investigations, for the same surface properties and shape, nanoscale particles can perform even better than micron-size platelets. Additionally, it allows for customisation with other therapeutic substances such as medications and targeted therapies.

Bloodborne pathogens and other infectious agents could be minimised with antibiotic-carrying nanoparticles. Particles could be made to fulfill certain requirements to travel to certain parts of the body - across the blood-brain barrier, for instance - for better diagnostics and truly targeted therapies. They are also cheap and have a long shelf life.

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