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04.06.2025 08:00

She is reprogramming cells to cure diabetes

Media Abteilung Kommunikation
Schweizerischer Nationalfonds SNF

Ekaterine Berishvili, a surgeon turned tissue engineer, is now focused on developing bioartificial pancreases. She has honed and applied her expertise across Tbilisi, New York and Geneva.

"One day, as I watched a lump of sugar dissolve in my tea, I became aware of the fragility of existence." It's this memory that Ekaterine Berishvili recalls, explaining what prompted her to take an interest in medicine at the age of 13. She now understands this as a need to be close to death to understand and combat it. "Even though I didn't realise it at the time, I think I was fundamentally opposed to the idea of anyone dying." After a pause, the 51-year-old researcher added, "And I still am."

Now a professor in the Department of Surgery at the University of Geneva, Berishvili, who was born in Tbilisi, Georgia, is direct about her mission: "Our project is simple. We want to develop a therapy to cure type 1 diabetes, an incurable disease that affects millions of people, especially children." Her work uses a combination of tissue and cell engineering techniques to replace malfunctioning pancreases.

Research – a light in the darkness

Tissue engineering – the controlled cultivation of cells and tissues – is now a rapidly expanding domain. But originally, it was external circumstances that led Ekaterine Berishvili to pursue it. "We had a corrupt system in Georgia in the 2000s. There were power cuts, and, frankly, not a lot of prospects or hope," she recalls. Her turning point came when a professor at the Georgia State Medical Academy, who was exploring bioengineering approaches to treat liver conditions, welcomed young scientists into his lab. This opportunity became her "light in the darkness," offering her new prospects. "I hadn't really planned on doing any research," admits the researcher. "When I finished training to be a surgeon, some of my male colleagues didn't support women in this field, and I couldn't break through."

Thanks to her unwavering motivation and supported by her mother-in-law, who helped her look after her son, Ekaterine Berishvili carved out a place for herself in the field of tissue engineering research. “It was a promising niche, and so new that there was no real competition. I threw myself into it completely.” Berishvili earned a spot on a scientific exchange programme to New York, later returning for a postdoctoral position where she cultivated liver cells for regenerative purposes. When she returned home in 2008, she faced major obstacles in sourcing second-hand lab equipment and transporting the necessary materials to Georgia. Nonetheless, she succeeded in establishing her own cellular engineering lab and shifted her focus to the pancreas and type 1 diabetes. Her research centred on treating cells with precise combinations of molecules to reprogramme them, guiding their development to acquire specific functions and ultimately create tissues or organs suitable for transplantation.

Protecting insulin cells from the immune system

Type 1 diabetes is an autoimmune disease that affects the insulin-producing cells of the pancreas. In affected individuals, the immune system attacks and destroys these cells, halting insulin production. Without this hormone, sugar cannot be absorbed by the body's cells. The resulting metabolic imbalance leads to weight and muscle loss, blood acidification, and various cardiovascular and kidney problems. For people with type 1 diabetes, the only current treatment is external insulin administration. While effective, it is restrictive and palliative.

"To really cure these patients, we need to restore their ability to produce insulin," explains Ekaterine Berishvili. Pancreas transplants can be effective, but they are complex and risky procedures. A less invasive alternative is the targeted transplant of the pancreatic structures destroyed in diabetics, the insulin-producing cell clusters called the islets of Langerhans. However, this requires tissue from up to three donor pancreases to yield enough material for a graft. Moreover, all transplant options demand lifelong immunosuppressive therapy to prevent rejection. "There are three main problems," the researcher sums up. “A shortage of donor pancreases, the difficulty in ensuring that grafts remain functional over the long term, and the risk of graft rejection."

Ekaterine Berishvili vividly explains how tissue engineering can help overcome the challenges faced by diabetic patients. Together with her team, she is developing a kind of “cell house” by reprogramming skin or blood cells from patients. These tiny structures mimic the natural environment of the pancreas, complete with blood vessels and supporting tissues. They are designed to host new islets of Langerhans.

If these islets are reprogrammed from the patient's own cells, the immune system may still recognise and attack them. On the other hand, if the islets are derived from donors or stem cells, the body sees them as intruders. In either case, the immune system poses a threat. To prevent this, scientists alter the islets, equipping them with immunosuppressive molecules and protective camouflage, like disguising the residents of a house and shuttering the windows for safety.

Once developed, this entire “house” – with its hidden insulin-producing residents and protective features – could be implanted just beneath the patient’s skin. This minimally invasive site would serve as a secure base for the steady production of insulin the body needs.

Making a real difference

Ekaterine Berishvili now oversees all these projects from Switzerland, where she relocated in 2014. "My private life – in this case, my second husband – brought me to Geneva. I was 40 and didn't speak French. I left a laboratory running in Tbilisi." The researcher is proud of having established a new lab in Switzerland and securing significant funding from institutions such as the Swiss National Science Foundation (SNSF), the European Horizon 2020 research programme, and the Breakthrough T1D foundation. Yet, she also wanted to maintain ties to Georgia, remaining affiliated with various state universities. "If successful people leave completely, who's left?"

Her need to act and help is reflected in her involvement in international associations such as the European Society for Organ Transplantation (ESOT). "The aim isn’t just to talk about problems and propose technological fixes," Berishvili underlines. "It’s to develop practical solutions that will benefit patients around the world as quickly as possible." She is optimistic that the treatments currently being developed could be perfected in the laboratory within five years and made available on a large scale within ten years.

But Ekaterine Berishvili also loves exploring the world she is passionate about improving. She dreams of travelling to Papua New Guinea one day to see birds of paradise. Her guiding philosophy is: "You have to make the most of the little time you have to admire the beauty of the world and help where you can." Her outlook on life is inspired by Albert Camus, among others. "He strikes the right balance between the absurdity and beauty of life."

The text of this press release, a download image and further information are available on the website of the Swiss National Science Foundation.

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Wissenschaftliche Ansprechpartner:

Ekaterine Berishvili
University of Geneva
Faculty of Medicine - Department of Surgery
Tel: +41 22 379 51 13
Email: Ekaterine.Berishvili@unige.ch

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Weitere Informationen:

https://www.snf.ch/en/xO3AS7MmP1bDHd2R/news/she-is-reprogramming-cells-to-cure-d...

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Journalisten, jedermann
Medizin
überregional
Buntes aus der Wissenschaft, Forschungs- / Wissenstransfer
Englisch

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