If we're controlling the cells' genomes (which we are), we can add any sort of killswitch (see another comment https://news.ycombinator.com/item?id=45220068 ) that we would like, and this would function better than relying on host immune surveillance. The opposite could be done, making insulin release dependent on the presence of a harmless drug, e.g., insulin release can only happen if a designer steroid molecule is present in the blood.
There are already cell therapies that envisage permanent implantation of modified cells, so I am not sure why a long delay for 'any type of usable treatment' would occur. The structure of this need not be analogous to a stem cell transplant; you could imagine injecting new cells intramuscularly every few months.
The costs to develop this are incurred during development (unlike the autologous therapies that require extensive, expert-level analysis for each new patient). I'm not sure that we can compare the current levels of investment in autologous gene editing to this product.
So, a subscription... ouch.
I get the medical advantages, but it still sounds as easily abusable economically.
You are correct that current cell transplant therapies exist, but I don't believe any before have contained these immune escaping edits and I believe all of those treatments are cancer treatments which allow for a different level of risk. Diabetes is a very serious disease but a quality of life treatment does exist and having cells result in a potential cancer in patients would not be acceptable as an outcome.
> once you start adding more than one item to a cell it doesn't always work out.
Very true, but the amounts of money at stake would justify the relatively inexpensive cost of hooking cells up to the already-available ER/TR-responsive gene elements.
> but I don't believe any before have contained these immune escaping edits
Hard to say, I'm not an expert on immune escape. It's an old idea, however, so I imagine it's been used in other pre-clinical or Phase 1 settings.
> I believe all of those treatments are cancer treatments which allow for a different level of risk
I imagine you're speaking about allogeneic treatment? Either way, this isn't true at all - here's a list of current treatments for diabetes alone: