A business making plastic bottles may not be the most obvious connection to diabetes cure research, but in fact a family-run company has a 25-year history of supporting the Miami-based Diabetes Research Institute (DRI). In fact, much of the DRI's work is supported by Biorep Technologies, run by a family impacted by diabetes, that makes essential equipment for the diabetes research community.

Biorep is actually a spinoff of the original plastic bottle company established by Florida diabetes dad Ramon Poo (pronounced Poe), and it's now one of the leading medical equipment suppliers in the world. You might be fascinated to learn that one of the key pieces of equipment created by this company and used by the DRI (and in islet research worldwide) made an appearance in a Grey’s Anatomy episode a few years back.

The DRI connection was fueled by Poo’s daughter Cristina, who was diagnosed with type 1 diabetes at age 3 in the mid-70s. Not long after her diagnosis, Ramon and his wife Tina found the emerging Diabetes Research Institute (DRI) as a way to tap into hope. The institute was just getting started in 1971 at the University of Miami.

In the years since, the non-profit has grown into an international network of research centers and scientists – and Biorep has been an integral part of their story for the past quarter-century.

“We try to do all we can to help,” Poo says. “The DRI is a unifying force facilitating some of the most promising research, simplifying and unifying protocols in using this equipment.”

 

The BioHub and beyond

As many of us who follow diabetes research know, the DRI has established itself as a global leader in this area, and has famously promised to find a cure for type 1 diabetes in the foreseeable future.

In recent years, the institute has been largely focused on islet encapsulation technology and related science for a “biological cure.” For the past several years, they’ve referred to that project as the BioHub – a bioengineered “mini organ” that mimics the native pancreas, containing insulin-producing cells inside that can function long-term.

While work continues and multiple BioHub "platforms" are being tested in pre-clinical and clinical studies, DRI researchers are also intensely focused on developing strategies to eliminate the need for anti-rejection drugs and halt the autoimmune attack that causes the onset of the disease, and on developing an unlimited supply of insulin-producing cells. And in mid-2019, the DRI highlighted important research showing that several adult PWDs who'd received islet transplants remained insulin-free, for as long as 7 to 16+ years!

All of that has proven DRI to be one of the leading players in the diabetes cure research space through the years. But remember in the mid-70s, the DRI was still very much in its infancy trying to find its footing.

New D-parents Ramon and Tina liked what they saw at the young DRI in south Florida, and after meeting with Dr. Daniel H. Mintz (who’s since retired but serves as DRI Scientific Director Emeritus), the couple singed on to help raise money for turning diabetes research into a cure.

But Dr. Mintz also mentioned the DRI had been having trouble getting proper equipment for their research. 

As an engineer by trade and owner of a Miami-based plastic bottle manufacturing company called Altira, Poo knew he could do more to help the DRI on this front. 

They helped out on the manufacturing side at first, but it wasn’t long before Poo decided they needed to separate those efforts from the plastic bottle business. They formed Biorep in 1994, as a pro bono engineering partner helping out DRI. Eventually that evolved beyond just South Florida, and into other areas beyond just diabetes. 

 

Inventing equipment for islet cell encapsulation

The DRI’s current director and lead scientist Dr. Camillo Ricordi was still working in Pittsburgh in the 80s when Poo remembers meeting with him there to talk about his vision: islet encapsulation. They made some sketches and got to work, and eventually Dr. Ricordi joined DRI and made the move to Miami in the 90s. BioRep’s original manufacturing focus was on two pieces of equipment used to isolate islet cells from the pancreas, which have now been dubbed the Ricordi Isolator and the Ricordi Chamber. 

Ricordi Isolator and Chamber: These were produced by hand in the machine shop in very small quantities, originally from stainless steel – but that was difficult to shake during the islet isolation process and didn’t allow for visual analysis of the process, so they shifted to an injection-molded translucent, high-temperature, autoclavable plastic. As a result of that metal to plastic change, Biorep was also able to move toward mass production and lower costs. This is now being used across the world in the islet cell space for diabetes research.

Oxygen Sandwich Petri Dish: Another research technology developed jointly between DRI and BioRep is a silicone membrane petri dish. While a standard plastic dish allows oxygen in from the top, DRI scientists wanted to test a dish that would allow oxygen to seep in from both the top and the bottom. That proprietary silicone blend enhanced the oxygen permeability, and the design was dubbed the “Oxygen Sandwich” because it envelops the cells in oxygen from both sides.

Glucose and Cell Testers: Biorep’s perifusion system is a machine developed to allow different substances to be put into different chambers and exposed to varying types of glucose. This is used in efforts to create different drugs to simulate what the pancreas and islet cells do. It has mainly been used for testing pancreatic islets in-vitro, solving two major challenges in cell secretion analysis: throughput (measuring the speed of effectiveness) and repeatability (allowing successive measurements under the same conditions). Notably, Poo tells us the global company Nestle actually purchased this machine to test the effects of their products on the body.

“To be able to think of something or a new concept and be able to work with an engineer to transform that and find a solution, is a dream come true for any scientist,” Dr. Ricordi says in a DRI video about the org’s work with Biorep.

 

BioRep’s surgical success

From its beginnings attempting to help the DRI, Biorep has become one of the leading manufacturers of surgical heart equipment, with patents on some of their instruments used for open heart surgery.

Poo says their leading product is used for minimally invasive heart surgeries, so the surgeons don’t need to open up the chest but can instead perform just a small perforation procedure. Medtronic – whose biggest overall focus is its cardiovascular division – is Biorep’s biggest customer in that area. 

With just about 30 employees, Biorep now has equipment being used in 30-40 countries around the world, and within each country (particularly larger ones like the USA) there may be multiple centers using their products.

 

Giving it all for research

Their core passion remains supporting advancements in science.

“Through our equipment and manufacturing, we’re trying to improve on the research that’s being done by the scientists around the world,” Poo says.

When they look to create a solution, the process begins simply by meeting with scientists to determine the basic unmet needs for their research work. The scientist may describe what they’d like to see happen, from isolating cells to refining and containing different substances or mechanical processes. They’ve even had sketches on napkins spark the process of creating a new piece of equipment.

Aside from aiding the lab work itself, Biorep’s products help researchers (at DRI and elsewhere) to publish important papers and even raise money for the cause.

Notably, Poo tells us that while Biorep does hold many patents on their DRI-derived projects, they don’t actively enforce those. So if another company can build upon BioRep’s work and create an even better piece of equipment, that is something Poo endorses!

“We’re trying to improve on the research and we’re open about it,” he says.

With all that, it’s not surprising that Poo has received multiple humanitarian awards for his work over the years. In our phone interview, we found him to be a modest and humble man, who doesn’t take credit or boast much about his contributions and accomplishments.

But it’s significant that he was recognized as one of the original “thousand points of light” recipients mentioned by Former President George H.W. Bush in his famous 1989 inaugural speech – referring to organizations and individuals working to make the world a better place. That honor was a complete surprise, Poo tells us, when the letter arrived from the White House in 1991. He now has that letter framed beside his desk.

 

Getting close to a cure?

Poo admits that it’s thrilling to watch the DRI’s research evolve through the years and be so intimately involved in making it possible. But at the end of the day, he too is longing to reach that end-goal finish line of finding a cure for patients like his daughter. 

“The impact of all of this is worldwide,” he says. “If we can help provide a solution to something to help (the DRI’s) research, we will do that. Sure, we could move a little faster in developing a cure, but I feel that we’re getting close.”

Poo says that Biorep makes a small amount of revenue from various partnerships and equipment sales that is donated to the DRI. But his original plastic bottle business remains the main source of funding for what BioRep does in diabetes and medical equipment.

Meanwhile, he points out that his T1D daughter, now in her 40s, happens to work in the accounts payable division of the family bottling business, and overall is doing fine on the diabetes front. She’s hanging in there quite well until there is a cure.