so as I said it is like more than three
thousand years of history this this is

us God and in Indian literature or the
Hindu scripture it has been recorded as

a mod Omega so the people who are
infected they urinate or this urine is

basically sweet and the anti and flies
are really get attracted because of the

sweetness I mean 200 and 250 BC
Apollonius vmm from Memphis he's coined

the term diabetes and that is to go
through basically it's passing the water

basically that's what it is and then
later on the mellitus which is a word

for the honey which is included into it
and in 1500 BC over this sorry in a 150

BC people realized that it is only
mainly associated among the women's and

that's what you know the more and more
knowledge has been developed in recent

years the recently still 300 year back
John Kohler documented excess of sugar

in the blood and urine 1831 were not
basically linked the diabetes to the

glycogen metabolism than the in 1869 the
Paul Legrand's basically Turman found

this discovered islet cells in the
pancreas islets of langerhans that's

what it has been called after that in
1889 Joseph and Oscar basically created

diabetes and dog by removing the
pancreas and in 1910 the insulin

you know it has been proposed the
chemical which is involved in

controlling the glucose in the blood so
that's what the history about the

diabetes and I mentioned few minutes
back that diabetes is divided into three

different classes mainly type 1 type 2
end just a little diabetes the number of

people which are basically with these
visas are you know 30.3 close to million

people in United State itself so if you
look at that number it is one out of 10

the people who have got the diabetes
type 1 diabetes is an autoimmune

disorder and it's result from the
insulin dependence and commonly detected

before the 30 years of age more than
18,000 youth are diagnosed each year and

5% of total diabetic population is type
1 diabetes basically type 2 diabetes it

is a basically metabolic disorder and
lack of insulin production all the

insufficient use of the insulin and
that's what result in type 2 diabetes

commonly it is seen after the 40 years
of age but nowadays you know the way our

habits has been changing you see earlier
than that and many of the diseases are

like or increase recently more than
5,000 users are diagnosed each year and

it account for more than 90% of the
cases contribute to this type 2 diabetes

in gestational diabetes which is like
during the pregnancy it is sin and

nobody knows the mechanism behind it but
3 to 5 percent of the pregnant human

eu-us develop this diabetes it is a
lifelong chronic disease basically and

it is associated with multiple
complication different organs are

getting affected by this disease so for
example the brain and cerebral

circulation eyes you know you get the
retinopathy basically you're the oral

health is decreased your cardiac
function is reduced your kidney

functions which
proper the peripheral nervous systems or

your the lower limb sensation which
affected and that ulcerative food that

is the some of the main complications
and to give the idea about you know how

do you washing this this is is like
everyday 3,800 Americans will diagnosed

with diabetes out of 200 Americans go
under the amp addition every day pretty

much and 1:36 enter the stage of kidney
disease which is really you know major

problems and then more there are close
to 2,000 develop severe retinopathy and

the blindness which is developed so
looking at this is a very you know

complex and very life-threatening
disease and obviously the cost

associated with the disease and with the
treatment is going to be are too much so

in America we spend more than three
hundred and twenty-two billion dollars

for the treatment of the diabetes or
taking care of the patients with the

diabetes and which is like almost 30
percent of the Medicare which goes for

the treatment of the diabetes and which
is close to 20% of the money from the

oral health care system is utilized in
taking care of the diabetes so talking

about all these stats and everything you
know what we know and as I mentioned the

type 1 diabetes is autoimmune disorders
and it is one of the disease there are

like more than 100 autoimmune disease
there and now we know at least after

3,000 years in last 50 years we started
understanding that there are multiple

genes are associated with most of the
autoimmune diseases there is imbalance

in the immune system which contribute in
the development of this autoimmune

disorders and then the very important
facts are the environmental factors and

that's what one should really look into
that is a pesticide fertilizers microbes

virus bacteria and other industrial
population pollutions which contribute

in development of many of the autoimmune
diseases the next line I'm going to show

you you know the number of different
genes in a world in the type 1 diabetes

per to say so
the pancreas is the organ which is

mainly in oil in the diabetes and there
are 20-plus different genes are altered

or mutated and which directly contribute
to the dis functioning of the insulin

production then the immune system plays
a very important role and there are more

than 100 plus genes are really people
have identified which are involved in

development of type 1 diabetes so it is
a very complex disease so there are lots

of genes which are involved so you know
people are thinking about that ok we can

use a CRISPR technology or gene therapy
can we fix all those different genes at

a time so it is going to be a challenge
so talking about that I'm going to take

you know this is on this slide little
bit extra time to just make you

understand what exactly is going on with
the diabetes so as I said that it is a

genetic factors mainly plays a role and
you have seen that number of genes which

in all and you know we are not going to
talk about each and every gene we cannot

take that much of you know we don't have
that much of time but I think I'm going

to try and use this one so in normal
circumstance you have enough islet cells

in the body and the way the slide is
divined that like what is happening in

the periphery is shown in the top what
is happening in the pancreatic

lymphnodes
and what is happening in the pancreas

which is shown here so in normal
circumstance of islet cells in the

pancreas which are there something
happened with respect to genetic factors

with respect to environmental trigger
where the viruses malaysians you know we

are nowadays we have the so many of the
pesticides and different fertilizers

which we are using all that somehow
contribute in terms of you know somehow

altering the u.s. islet cells the
interferon alpha which goes I mean this

is I'm trying to simplify the nature
don't work that way just keep in that

mind that nature is more complex and as
a we scientists we try to simplify

everything and make it more complicated
but anyway talking about that we

and that there are certain things
happens and as a result the eyelets your

own cells start calling the
administration saying that we are

foreigners or something like that
as a result you know the and at the same

time somehow there is there are the
cells which really suppresses the

Ottoman disorder by the they are called
the T regulatory t-cells basically so

their population start going down
somehow around the time the cells islets

are showing that we are foreigners
somehow you know they they they behave

weirdly as a result there's the cd8 T
cells which are the killer cells they

come inside and they start killing you
are the islet cells during this process

you know more antigens are get processed
and presented by dendritic cells and the

cd4 cells comes in to the feature which
is a helper cells which is a important

part of the you are a human system and
that leads to the development of the B

cell clone which are going to produce
the auto antibodies against the insulin

as well as a different islet cells which
are there different time and we will

talk about that also shortly when this
whole process happens and then you are

producing more antibodies you are
killing more of the your own islet cells

and then as a reason all the time
the production of the insulin start

going down going down and here are some
little bit of the honeymoon phase and

the style changes with different people
and as a result over the time you are

going to have less amount of the islet
cells which are going to produce the

incident which is a key component in
your metabolic things so the point you

have to remember from this light this
something happens and the T helper T

cell imbalance occurs and there are four
major component of the helper T cells

which th1 cells th 2 cells th17 and t
reg cells and was that happened at the

same time and these are the other than
the T helper cells other company of the

immune system also goes out of the
control and all that result in the

destruction of the u islet cells
basically so

in this slide I'm just going to know
what is this penguin and what is this

I'll it says basically so everybody now
know that ok the when the pancreatic

function is impaired so less amount of
the insulin is going to be produced and

the islet cells are consists of
basically your the main our beta cells

alpha cell delta cells and gamma cells
and these cells produces more important

hormones basically insulin and a myelin
by the beta cells alpha cells produces a

glucagon Delta cells produces
somatostatin and gamma cells are

polypeptides and all these hormones are
really important in terms of metabolism

and how the what we eat food is process
and get absorbed by the different part

of the body and out of that the insulin
is really the key component of the

system so and that's what we just
initially identified that that's the

molecule which is yet impaired so what
we know about so so insulin is a very

important molecule and it is involved in
regulating more than hundreds of genes

in the body it is involved in the uptake
of the glucose for example a very simple

and which is the key component of your
you know activity of the body it

involved it's a pretty late the
glycolysis it in all in glycogen

synthesis protein synthesis uptake of
the ions which is potassium ion the

waste on which you are the cardiac
functions and many other muscular

activities are going on insulin is
involved in controlling or they in

negatively or inhibiting the glycol
neurogenesis gluconeogenesis

glycogenolysis lipolysis ketogenesis
so it is a very important molecule

involved in the metabolism basically
that's what the main thing you guys

should remember and you can look into
what are the different things are really

affected so what is the treatment for
that everybody knows that the insulin is

missing in type
diabetes so the treatment obviously for

the type 1 diabetes is going to be the
insulin so is there cure there is no

cure for the type 1 diabetes right now
so what are the things you can control

you can keep on checking your the level
of the glucose in the circulation you

take the insulin you monitor your
milling van right now and do the regular

exercise that's what the options which
is there with the type 1 diabetes

basically and this molecule which is as
I mentioned it's discovered in 1921 it

is consists of alpha and beta chain or a
and B chain it has got three disulfides

two disulfides in the e allow a chain
and then their other a and B chains are

connected by the by the disulfide bonds
there are different kind of analogs

which are available right now to take
care of the diabetes so start acting

rapid-acting you know the the one which
are like long lasting so based on that

and nowadays you can have the different
kind of the treatment so insulin is

there people have done lots of studies
to getting more insulin and then there

are the pumps which has been developed
also to inject the insulin so talking

about the pump you know in 1963 the
first pump which has been developed by

there are now carriage and you can see
that the the size of that insulin pump

people used to you know have that time
and then over the time it is really

developed so much that recently the
pumps are like less than your credit

card size basically overall so that kind
of the development which has happened

Medtronic is doing I know great work
with respect to the development of the

pump so with respect to this device and
for the treatment of the type one

diabetes there's a lot of things which
are going on I'm just going to take

minute or two to talk about type 2
diabetes and treatment options which are

available so type 2 diabetes as I told
you it is like

develop because we do less exercise we
sit in front of the computer for a long

time and that is one of the main culprit
second thing is that the kind of food we

what we eat you know the right now I was
just watching you know everybody was

eating too much of the pizza and I iced
I really you know did bad things to my

health by eating the pizza I used to eat
70% of my lunch and Dina used to be

pizza and I'm not you know said don't
eat it but you know everything in

balance is really the important thing
and then eating on time is really

another important thing I will tell
everybody sleeping on time is really

important thing and these are the basic
things we start missing and then we use

too much of the pesticide we use too
much cleanliness is also not good

sometimes that's balance is required
everywhere nowadays we use this the

stroller Isis right sanitizers you know
and you know how many people really

think about you know those sanitizers so
we they claim that we kill 99.9%

bacterias what happened to that point
one person anybody think about that you

know anybody think about that we kill
99% you know know those bacterias are

competing with each other so think about
that if you remove that you know that

competition now the one which has
survived which are the really the bad

one because they are the resistant to
what you are using and now you remove

the competition for them so what is
going to happen you know it is like

simple logic things you know as I know
that we do a great job in advertisement

and we get the carried away with it but
we have to think you know out of the box

always logically that what we are doing
is right or not okay but coming back to

the type 2 diabetes so once we identify
okay there is a step 1 is that diagnosis

ok you know that okay there is a problem
so first thing doctor always going to

say let's change the lifestyle you know
do the exercise regular exercise

and in metformin is a common drug which
is given but if with that if the a1c is

not control and it goes above a 1 C is
basically amount of the glucose

accumulate on your RBC's or your in the
different you know proteins which are

there so once that is happened that way
and then you are to go with more

therapies basically then in the I know
you add two more drugs like your

metformin will appear and there are the
additional drugs which are the sulfide

release kind of the drugs which will be
there if that also don't work then you

go with a med forming along with a bit
insulin basically and then there is a

start to basically in which you have the
more the drugs which people have

identified and you can use those and
then if nothing controlled still then

the main thing is that you go on and try
to change the lifestyle how the

metformin and then the intensive insulin
therapy that's what only the option

remain and our next slide this is the
six different classes of the drug which

is used for the type to try bleach
treatment and I'm going to share this

some of the slides so one can you know
look into it I'm not going to spend but

what is okay the limitation of current
therapies is obviously the glycemic

control so you have to break every day
to look at you know how much blood

glucose is there and then the idea is
because you have to keep on you know

taking this insulin injection we have
the finite body space and how many

injection are me every day one has to
take like three to four injections and

think about it that is really painful
kind of the time so these are the main

kind of the caviar or the of the
limitation of these therapies as well as

the or else you know integrates of the
type 2 diabetes it is a chronic disease

so every the patient has to take every
day three times or four times of spills

and which is really you know the ideal
ends become the problem another

limitation of this therapy insulin
therapy is the define you have to

fine-tune the glucose you know there and
that's very important thing if too much

of the glucose in the body
is bad 2 liters is also bad because you

will go into coma so you have to have
that violence so you have to monitor it

frequently risk of severe hyperglycemia
and the main thing with respect to

insulin therapy is that you miss the C
peptide which is like you know if you

look at the insulin the way it is it is
a pro incident-free Pro insulin and then

C peptide and initially people did not
thought that the C peptide is important

but now they started realizing that is
also very important component and when

we give insulin we agreement process
insulin next important thing is that

when we give in you know insulin we give
only insulin we are not looking at other

hormones which are missing like
somatostatin glucagon in a polypeptide

there are so many other things which are
required and which are missing in type 1

diabetes so these are the main
limitation of the insulin therapy and no

doubt I'm you know now that pumps the
people are developing they can pump the

insulin as well as the glucagon
simultaneously but still these are in

the initial phases many of those things
so next part of the topic talk is going

to be on the organ transplant and cell
based therapies what people are now

developing and I'm going to you know
talk you know just show you this slide

to look at the complication which are
associated so the people like small

molecule like aspirin I look at them as
like a bicycle it's a very simple kind

of device next thing is like insulins
which are like a no biological molecule

but they are on five to ten thousand
darkins in range and they are like you

know the car you can say then there are
the non biologics which are complex like

your the heparin molecule low molecular
beauty parent and all those those are

like you know kind of the helicopter or
something like that and monoclonal

antibodies which comes into the picture
which are like you know jumbo jets which

are highly complex and then we are
entering into the phase of this

nanotechnology and cell based therapies
according to me they're complex like in

galaxies you know where is the universe
and when we look at like organ agenices

or the encapsulated cells that is
further more complex

and we cannot understand our planet
itself so how do we can you know think

about that complex things Multi was kind
of the thing so those are the

complication associated but still we
have to work to find a good treatment

and one of the thing you know early on
people decided okay the organ transplant

you know you if the pancreas is the
problem can why not we transplant the

pancreas and it's a good option and
really it shows a very good cure eighty

three percent of the people show very
good in a control in the glucose levels

however the limitation obviously
shortage of donors how many you know

donors are available and that is the
main problem and then the second thing

is that because you are putting the
somebody's else spankers into the

patient no human system is going to act
against it so that is the reason your

put the patient on the immunosuppressive
therapy and that is a lifelong once

again so these are the main problems
associated with that and to do the organ

transplant you know Penn College is very
you know delicate kind of the organ and

there are a lot of things associated you
know transporting that organ from one

place to another so people started
thinking you know you stop doing the

complete organ transplant can we take
out the islet cells and put it into the

body to take care of the insulin
production and that's what early on in

almost like this is also going on for
last twenty five year plus and it is a

obviously it is very instead of the
using whole organ it is a non-invasive

it is the less expensive way it's
supposed to be and it is it is basically

you can culture the islet cells in vitro
people there are some people say you can

prolly
you can expand but it is not really

possible to expand that very well
and another important transportation and

storage and all those things become
easier and another important thing you

should remember that Eureka you get all
the alpha cells beta cells

says whatever is required you can get it
and then put it into the patient so

these are the Edmonton protocol which is
commonly known as and I just developed

in Canada and multiple patients has gone
through it so this is a simple thing

from the donor you get the pancreas you
process it and there is a recorded

chamber which is where you digest the
pancreas to get the islet cells and once

you purify the islet cells by using the
scope and everything the spirit for

islets then you know put in the culture
and then they are put into the back into

the patient who is on immunosuppressive
therapies there is a one second of

limitation everybody can understand it
is a source you know how many karevik

sources are available and then there are
the immunosuppressive therapies has

their own drawbacks and their own
limitations so but there is a really

good success story associated with that
Minton protocol in the early 2003 I

think that's what it is yeah you can see
that there is not too much of the

control in the on the y-axis you are
looking at you know beta cell insulin

secretion basically capacity not too
much it's secreted over the time because

the process is not that very well
developed but recently if you look at

that from 2008 to 2012 you can see there
is a really nice amount of insulin

production so the isolation product
process and transplantation has really

improvise over the time and this
basically is leads to the new new

concept of using the stem cell therapy
for the treatment of the type 1 diabetes

so because of the there is a limitation
of my amount of pancreas available from

the human so one can really use a stem
cells and or the genome islets and

produce more amount of the islets for
the transplantation but there are the

challenges which are associated with all
these both the therapies like using the

stem cells as well as the xeno islets
basically so advantages

this advantage advantages is
availability very easily to isolate and

expand but with respect to the your
stencils it is a difficult to

differentiate them in the proper way
like the you require alpha cells beta

cells Delta cells gamma cells can you be
able to do that and it is possible over

the time it is going to be happening but
right now there is a limitation with

respect as you know eyelet where you can
take the PO sign you know you can have

as many as eyelets from the PO sign and
the post on insulin is very close to the

human insulin so that's the reason
people are looking into that

disadvantages still the growing the
islet cells from the stem cells

you know it's expensive because of the
growth media and everything and that is

controllable over the time you know that
price can go down in case of the Zeno

islets it's expensive because you have
to grow that big into the clean

environment and that is going to be the
really expensive stuff because to grow

the big into the clean environment it
caused you know per peak like more than

one hundred hundred and fifteen thousand
dollars then in case of the stem cells

the limitation is we know you may still
get the beta cells you don't get Alpha

Delta and other components in case of
the Geno obviously all the subsets will

be present their safety you with respect
to stem cells people worry about

immunogenicity which is very poor sign
they are not but immunogenicity is going

to be yes and no you can mo genetically
modify and reduce the immunogenicity for

the stem cells same thing can be applied
to the pool sign but obviously it is a

Geno genic project product so you are
going to have the more unique responses

safety with respected Geno viruses with
the pol sign so there is going to be a

you know more Geno viruses issues and
obviously there are the ethical issues

because some people will not like you
know to go in through the Sinai lattice

at the same time sell products some
people don't like it okay I'm very close

so let's let's go through couple of you
know so one of the things keep in mind

that you now require all the different
cells upset basically

I'm just going to go away from this one
also so one can use this now the islet

cells and one of the important caveat
you're using the islet cells from this

Zeno or the stem cells is the immune
cells or immune system look at as a

foreign thing so you have to isolate
them from the immune system and one of

the technique people are using is
encapsulation technology so you

encapsulate the islets and so that your
T's your the human system will not go

and attack it the antibodies cannot
penetrate to destroy those islet cells

and at the same time the nutrient can go
inside oxygen can go inside and this

device or these micro devices or micro
encapsulation secret the insulin out and

that's what which is really the goal of
many of the people and then obviously

you can genetically engineer the cells
and overcome them in responses so there

are lots of different companies who are
working on encapsulation technology and

we are one of the technically who is
developing this encapsulation technology

so our technology is like we take the
Poussin islet cells we encapsulated

using the chemical called as a alginate
and we have identified the molecules

which can keep the immune system at the
bay and that's what our idea is that so

they aim is simple that the cells will
produce the insulin and that will be

continuously delivered in the body and
in the control fashion and obviously it

will be used for the type 1 diabetes so
this if we capsid molecule which I was

talking about so that molecule is
involved in attracting the T regulatory

cells at the transplant site its block
the CTL attacked it can increase the

angiogenesis or track the stem cells
suppresses the why you know why maintain

formations and it can inhibit the
foreign body reactions basically and

that is what I know and one can I did
there are the molecule available in our

body itself like eyes pancreas testes or
is this

the human privilege organ they do
secrete some proteins which keep the

immune system at the base the image
system cannot attack those organs

basically so we identify some of those
molecules which can be used in this

encapsulating material and which can be
routed over the time to keep this no

islet cells protected another important
thing one has to keep in mind that I let

sell themselves are the immuno protect
they have the human privilege kind of

the capacity so they can secrete
themselves immuno immuno protective

molecule so if you can maintain the
health of those islet cells they can

create the environment around them to
keep them in a healthy condition so our

product how many minutes I have 10
minutes right so our product is like we

are you know take the neonatal poster
the peak isolate get the pancreas then

prepare you know means they do the
collagenous digestion and then remove

the debris and culture to get rid of the
ice in our cells and other cell type and

just by simple culturing process enrich
the islet cells population once that is

enriched by day six we go and
encapsulate them by using the Buchi

quipment basically and once those are
encapsulated once again we culture them

so that they can mature and because this
whole process itself is a stress

inducing so always you ought to think
about that if it is something which has

gone through the stress it is going to
be not in a good health it's not going

to be going to able to protect itself
from the immune system attacks so you

have to culture it for some time
once it is come to the normal state now

you can put it in back into the body and
here you know in the preliminary product

we are planning to put it into O Mendte
which is one of the major organ in the

body and that's what our idea of doing
it but to do all this thing you know you

require the very good quality you know
healthy Peaks basically which are grown

in the clean environment you require the
GMP

be like you know solely processing
encapsulation technology you know how to

have the preclinical data and that's
what we are working on right now and

then you know you go into the clinical
trial if you have the time I'm not I

will go through this slide and then the
couple of next slide will just omit it

so to develop any of the product you how
to optimize you know like in our case

there is a recaps in the molecule which
keep the immune system at the bay so we

have to optimize the concentration how
much it should be released

what can we release candidate what are
the different molecules we can use which

has got more half-life or the better
half-life so we have to optimize that

you have to optimize the isolation of
the in neonatal post on islet so you we

have looked at age of the piglet strain
and source of the piglet the enzymes

which used to digest the pancreatic
islet cells culture conditions so there

are a lot many things when I have to go
through it and then once you isolate and

you have to do the encapsulation
so in encapsulation you know you have to

identify different alginates which is a
based one you have to optimize that

process of I know encapsulation what how
does that molecule is going to affect

that we caps in that the release of
those cytokines or the immunomodulator

molecule and how good those
encapsulating agent is involving

exchange of the waste product and a
nutrient how does the glucose is

crossing over how the insulin is coming
out and glucagon so so you have to do

lots of different things before you
develop the good product and that's

where you spend more time in developing
and any drug development like small

molecule drug development take 8 to 12
years to from the start to the finish

from the rnd to the clinical trial where
the biologics are going to take a little

bit longer than that you know so it is
very anywhere between 8 to 15 years once

you just start developing it so I'm just
going to you know skip this slide and

skip the slide so just to give you the
idea I know

no doubt that we can clear this micro
eyelids now micro eyelids once you put

it inside these are the gino product or
the eyelid suppose in the case of the

emergency if you have to remove all that
product out you need some way to remove

it and that's the reason people are
thinking about developing macro pouch or

the system by which you can keep this
micro capsule inside there another pouch

and in case of the images you can able
to remove it so one of the project we

are working on is decelerate organs one
can use it and the pancreas you know

from the different spaces you can use
and that do help the islet cells to grow

efficiently and one can use those kind
of the pouches to put this micro capsule

inside and then put inside the patient
and that can work as a good pouch and

that is one of the long-term kind of the
thing currently we are working with

another company called as a so NOAA
company where you know if you know the

Edmonton protocol you get the islet
cells and put it into the lever and

hoping then the lever will produce the
insulin basically that's all the idea

but that doesn't work over the time
because over the time the amines

get a a system get activated and they
start killing as well as you lose the

both the function of the lever as well
as of the islet cells so here the the

approach we are taking is that cell
power system so you can clear it

initially to the patient you create the
pouch you know which can get

vascularized once that portion is get
vascular as properly now you can put

micro eyelets or a micro encapsulated
eyelets into that that's what the

approach you know some people are trying
to develop so talking about all this

thing you know whatever the future is
leading to and everybody remember this

slide that there are the genes immune
system and environment and if I asked

you guys one quick question you know
what you think will be the best you know

what you we can control out of this all
this three component very easily or

efficiently
things the environment right at least to

begin with so I think we have to work
toward that you know and young you young

people you how to you know think on that
how do we can take care of the

environment the amount of the plastic we
are putting in the sea is like I think I

heard that two billion tons per year and
that is scary and that is he is going to

come and you know bite back us you know
it is that's how the nature whatever you

throw to the nature is nature is going
to throw back to us so so please you

know that's some of the thing if we can
control in our hand that's will be the

important thing but once again coming
back to the self-weight serie series

what we want we want a therapy or we
want the devices or something which can

produce which can have all this four
component of the islet cells alpha cells

beta cell gamma delta at the same time
we can able to put them in the body

where it will be properly get
vascularized because if it is not going

to get vascularized they are not going
to get the proper nutrient if they don't

get new trend they are not going to
survive for the long time but obviously

at the same time the insulin has to
sense and it's sure a new glucose

actually be cells instrument has to be
secreted out so the west polarization is

very important thing another thing which
you know either we signed this very

forgetting is the gnosis neuronal system
so if you know it's really one has to

think about that insulin is secreted
just by the thinking about the food and

that means there is something else which
is happening and how do we can improvise

that neuronal you know innervations
basically so the when the islet we

implant it can they have the proper
neuronal stimulus going on and then the

important thing is that how we balance
the immune system and there are the

multiple ways people are working like
party cell therapies you know regulatory

cells to develop so it is going to be
next you know i will save in next 10

years there is a good possibility that
we will have the device you know which

we can put it and we can able to cure at
least diabetes in in terms of the time

you know this is the one slide which
talk of

where we are the pancreas
transplantation yes it is potential cure

and it shows 83 percent success rate but
that is not going to be standard of

choice because we don't have that many
you know donors available islet

transplantation yes it is a potential
and it's an experimental stage a lot of

things are going on stem cell
transplantation potential treatment

artificial pancreas devices lot of
things going on you know people are now

producing those devices which can
secrete the insulin glucagon

somatostatin and then the C peptide and
all that and then the

xenotransplantation is another approach
because many groups are working on it

which can you know take care of it so I
just take home a message for all of you

you know so always you know this is a
story I always liked about it it is from

the one of the sect called Mahanagar
sect which is about blind people you

know trying to see how the elephant
looks like and I know the people who was

touching the trunk they feel that he is
like snake the people who are touching

his year they feel like he's like you
know some kind of you know big cloth

piece you know the people who are try
you know they are feeling that he's like

some kind of the sharp object and so on
and so on basically so I want you guys

you know to be not like you know that
way but go beyond you know see the

complete elephant always and another
thing I always like to tell about a bee

I like that book and and I hope you guys
read the rigor mortis book the rigor

mortis book by the Richard Harris but
how sloppy science create a worthless

cures crushes hopes and wished billions
it is one of the nice book whenever you

get time you know it's it's really
important to read about and I think the

you young people are going to be the you
know key for the success so so please

don't be like those blind you know guys
look at everything with the open eye and

you know that's all thank you know if
you have any questions I will try and

answer if not I will you know give

ya know you know I don't make Edmonton
protocol you know you have to you know

see that they one of the main problem is
that when you do this transplant in case

of the Edmonton protocol also all the
time because you your immune system

still acting very strongly and that
initial process itself our surgical

process create the instantaneous blood
reactions against those transplanted and

they die so whether you have to do
multiple transplant is not like once you

do it it's done for it and that's the
reason you have to develop this macro

devices or something by which you can
easily pull the cells inside and every

six month or every you know one year you
can able to remove them and put it new

cells so which is going to be their
future

it has it as the alginate basically
don't allow you know it I will not say

completely blocks the antibodies to go
across we have done some of the studies

and it takes more than like I will say
48 hours to penetrate antibodies but see

just penetrating the antibody is not you
require the complementary factors also

going along with that and complete the
caption is providing like main thing is

that when you put these capsules inside
microcapsules the foreign body reactions

which start happening and then the
macrophages and which becomes a gigantic

you know cells and they start covering
that the capsules so over the time now

you are cleared and you and that's how
the immune system or the body

whenever the foreign thing is put inside
they create the cover on that and that's

how basically that whole thing is block
but the V capsule is not allowed to grow

anything on those micro capsules and
that's how it remain always a porous in

nature so it can keep on you know that
things get going if without a recaps in

you see the nice kind of the thin
membrane form or and then over the time

it's become thicker and thicker so I
guess you overcome those kind of the

issues with the V capture really see
that what we put inside is lasts only

for 72 hours but we found that if you
keep this eyelid healthy they themselves

can produce these molecules and they
keep on secret so it we can see that the

main point is in many of this cell based
therapies you can you keep these cells

happy and healthy in the first phase and
that's where many of the things which

are failing that we put down whatever
the cells inside the body when we do the

surgical process itself that itself
cleared in kilometer reactions you know

if you can somehow avoid that or somehow
reduce that impact you know and once

they remain healthy there for some time
many of the stem cells many of the islet

cells are going to produce themselves
the proteins which can keep the immune

system and the bay but that's the tricky
thing you know and the way sorry go

ahead
no I was talking about the way the

embryo you know take care of many of the
things it is a foreign thing which is

growing there for nine months but
without you know anything it can raise

so nature has really developed many of
the things we have to just understand we

identified many molecules when I was
working at one of the cell taxes company

which is incubator of the Georgia Tech
and we identified multiple proteins

which is secreted from the testes or he
Orion cancers eyes you know which can

keep the immune system at the bay and we
have to you know there is a way we can

do it I think over the time

are you planning to use 500 capsules of
what is the size of a past

the size that's a really good question
right now the size of our cap suits is

around 600 micron which is really a big
you know we have to you know there is a

way the technology is coming up where
you can have the citizens the the eyelid

itself are 150 to 350 400 micron in size
so you can have a very thin layer like 2

to 3 say that you don't require cell to
cell contact and if one can create that

very thin layer that's true it is but
that is going to be on of the challenge

you cannot go to this micro capillaries
and all that you can use as I know say

the thing is that these are the pancreas
extracellular matrix do help the islets

to remain healthy and there is some kind
of the communication which goes from

that post thing it will make sense but
as a proper kind of the vasculature I

really don't know whether it will really
work or one has to use a 3d you know

printing kind of database that you
create those and then those you know you

created the device and they can be put
inside and remote okay