Shadowing his physician father from a young age, James knew early on that he wanted to be a surgeon. He followed through with medical school at the University of Newcastle, and then trained in pancreatic surgery at the University of Bristol. His interest in pancreas biology and transplantation further deepened following a move to the University of Alberta, where he obtained a PhD studying the effects of various drug combinations after pancreatic surgery. Eager to learn from many minds, Dr. Shapiro then travelled to Maryland, USA to further master pancreatic surgery, as well as Vancouver and Kyoto to learn liver surgery from the best in the world.
In 1998, Dr. Shapiro joined the University of Alberta as Director of the Clinical Islet Transplant Program. This initiative aimed to develop a cure for type 1 diabetes through transplantation of islet cells. These islet cells are found in the pancreas and produce insulin to sop up glucose from the bloodstream.
The program had been dormant for five years before Dr. Shapiro took the helm, and the changes he made to their existing surgery procedure led to a pivotal breakthrough the following year. Of the seven initial patients living with diabetes transplanted under Dr. Shapiro’s revised procedure, all seven showed such recovery that they were able to eliminate insulin injections from their regime for many months, one patient for as long as two years. This procedure, famously known today as the Edmonton Protocol, has undergone further refinement since 1999, now guaranteeing a 5-year insulin-free life for 60% of its recipients. Over the past two decades, this procedure has been performed on almost 2,000 patients around the globe.
Today, Dr. Shapiro’s aspirations lean towards a yet more ambitious goal: creating a permanent cure for diabetes. In his own words, he hopes to “turn diabetes into a disease that is just like the common cold; it came and it went.” There are two major hurdles to overcome: transitioning away from pancreas organ donations (which are scarce) towards bulk islet cell production in the lab, and reducing the need for toxic anti-rejection drugs after transplantation.
To this end, he has spearheaded a collaboration with ViaCyte, a company utilizing stem cells as a treatment for diabetes. Since stem cells can mature into a wide variety of cells, Dr. Shapiro’s strategy is to extract a patient’s own stem cells, coax these cells into becoming islet cells, and then transplant them back into the patient to produce insulin. This approach, if successful upon testing in humans, would be much safer, more effective and more accessible than the groundbreaking Edmonton Protocol.
This initiative is undergoing a massive round of fundraising to enter clinical trials, aiming to raise $22 million dollars by the year 2022. Dubbed “HEADing to 2022”, the initiative is a celebration of the progress made in diabetes research since the discovery of insulin treatment 100 years ago, and also a call to help end diabetes for approximately 422 million people worldwide. To learn more, visit www.headingto2022.com.
— Written by Annoj Thavalingam