STEM CELL THERAPY MIGHT HELP COMBAT TYPE
1 DIABETES
A pilot
study of people newly
diagnosed with type 1
diabetes found that stem
cell therapy eliminated
the need for insulin
therapy for varying
periods of time. This is
the first trial to look
at stem cell therapy in
humans with this form of
the disease. But experts
stressed that the
research is preliminary
and urged caution when
interpreting the
results, which are
published in the April
11 issue of the Journal
of the American Medical
Association.
"This may
be the first step in
something that could be
promising, but I need to
see a control group and
longer follow-up before
I'd go out on a limb,"
said Dr. Jay S. Skyler,
author of an
accompanying editorial
in the journal and
associate director of
the Diabetes Research
Institute at the
University of Miami
Miller School of
Medicine. "But this is
worthy of further
experimentation." Type 1
diabetes develops when
the body's immune system
attacks the pancreatic
beta cells, which
produce insulin -- the
hormone that transports
sugar from the blood to
cells for energy. "In
type 1 diabetes, the
immune system is out of
balance," Skyler
explained. "Ordinarily,
all of us have some
cells with the potential
to destroy the pancreas,
but the regulatory
immune system prevents
those cells from
becoming sufficiently
active. In type 1
(diabetes), there's a
greater proportion of
activity of the
destroying cells and
lesser activity of the
regulatory cells. The
goal is to try to bring
that back into balance."
By the
time a person is
diagnosed with the
disease, some 60 percent
to 80 percent of the
beta cells have already
been destroyed. And
people who have more
functioning beta cells
tend to have fewer
complications down the
line, research has
shown. Immunosuppression
therapy, designed to
dampen the immune
system, can help, but
these patients still
need to take insulin to
regulate their blood
sugar. Meanwhile, stem
cell therapy has had
some success with other
autoimmune diseases,
such as lupus, but not
with type 1 diabetes.
"There has been use of
this specific procedure
in other autoimmune
disease in human beings
with some suggestion of
promise of effect, and
it's been advocated for
a number of years that
this kind of approach
might be useful in type
1 diabetes," Skyler
said.
The new
study, conducted by
scientists in Sao Paolo,
Brazil, and in Chicago,
involved 15 patients
newly diagnosed with
type 1 diabetes. All
participants underwent
high-dose
immunosuppression
therapy followed by a
procedure called
autologous
nonmyeloablative
hematopoietic stem cell
transplantation (AHST)
to preserve beta-cell
function. AHST involves
removing a patient's own
blood stem cells,
treating them, and then
returning them to the
patient. "Using bone
marrow precursor cells,
which are precursors of
immune T-cells, is
designed to reset the
immune system," Skyler
said. "The reason for
choosing a point early
in time is that you want
to have enough beta
cells that are still
left."
During
follow-up that lasted up
to 36 months, 93 percent
of the patients achieved
some length of insulin
independence. Fourteen
patients became insulin
free -- one for 35
months, four for at
least 21 months, seven
for at least six months.
Two more participants
who had late responses
to the stem cell therapy
became insulin free for
one and five months,
respectively. One person
developed pneumonia, and
two others developed
problems with their
endocrine system, which
governs hormones in the
body. It's unclear
exactly how the stem
cell transplants worked
their magic. And there
are still numerous
questions. "The obvious
question is how long
does it work and what is
the risk of treatment,"
said Dr. Larry Deeb,
president of medicine
and science at the
American Diabetes
Association. "But the
excitement is where we
are in diabetes research
and treatment, and the
excitement some of these
questions generate for
people who have diabetes
and for the diabetes
community and for the
profound argument that
this is not a time to be
proposing less money for
research in diabetes."
Source: http://www.diabetesnews.com/
