Umbilical Cord Stem Cells Successful in Treatment of Type 1 Diabetes
Umbilical Cord Blood Alters Course of Type 1 Diabetes in Newly Diagnosed
Mothers Keep On Giving…Stem Cells, That Is…
Umbilical Cord Stem Cells Successful in Treatment of Type 1 Diabetes
A new US study offers insights into the way stem cells from umbilical cord blood can be used to successfully treat diabetes.
Researchers at the University of Florida College of Medicine studied twenty children aged between two and seven with type 1 diabetes, seven of whom were injected with cord blood cells. The researchers concluded that the study suggests that the cells “jump-start” and correct the patient’s own immune system.
"This is the first attempt at using cord blood as a potential therapy for type 1 diabetes. We hope these cells can either lessen the immune system's attack on the pancreas or possibly introduce stem cells that can differentiate into insulin-producing cells," said the lead researcher, Dr. Michael Haller.
Type 1 diabetes occurs when the immune system starts destroying insulin-producing cells in the pancreas needed to control blood sugar. It can result in heart disease, blindness, kidney disease and death.
The children treated with umbilical cord cells needed an average of 35 per cent less insulin over the following six months, compared with those not given stem cell infusions.
The study was presented yesterday at the annual meeting of the American Diabetes Association in Chicago, where researchers cautioned against an overreaction. They said the treatment was not a cure and that the cause of the immune process in diabetes was still unknown, but Dr. Haller said that his team has reason for “cautious optimism.”
Another member of the team, Dr. Desmond Schatz, said, “We expect this effect will be transient, but we will be able to use it in other combinations of therapies.”
Juvenile diabetes is one of the most frequently cited diseases in media reports on the potential for stem cells to cure diseases; but news outlets rarely distinguish between cells taken from embryos or foetuses and the patients’ own bodies. Numerous studies have shown that stem cells taken from the patient’s own body–sometimes called somatic stem cells–as well as umbilical cord cells, produce favourable results for a number of illnesses, while the results from embryonic stem cells remain uncertain at best.
In late May, researchers from the University of Texas reported they had engineered adult stem cells derived from human umbilical cord blood that were able to produce insulin. “This discovery tells us that we have the potential to produce insulin from adult stem cells to help people with diabetes,” said Dr. Randall J. Urban, senior author of the paper.
One biotechnology company in Houston, Texas, announced in 2005 that it was exclusively using adult stem cells in its diabetes research. PharmaFrontiers developed a method of extracting stem cells from a patient’s own blood. Patrick Linbeck, a representative of the company said that like embryonic cells, stem cells from blood have been differentiated into every type of stem cell in the body, without the ethical or medical problems presented by embryo cells.
Adult Stem Cells From Human Cord Umbilical Cord Blood Successfully Engineered to Make Insulin
http://www.lifesite.net/ldn/2007/may/07052809.html
[29June07, Chicago, LifeSiteNews.com, Hilary White]
Umbilical Cord Blood Alters Course of Type 1 Diabetes in Newly Diagnosed
Researchers supported by the Juvenile Diabetes Research Foundation have found that transfusion of stored umbilical cord blood into a small group of newly diagnosed children with type 1 diabetes appears to have delayed the progression of the disease, possibly re-setting the immune system and slowing the destruction of their insulin-producing cells.
Desmond A. Schatz, MD, Professor and Associate Chairman of Pediatrics at the University of Florida College of Medicine and senior author of the study, recruited seven young children (ages 2 to 7 years at the time of infusion) with type 1 diabetes who had their own stored cord blood and infused them with it. This group was matched with 13 randomly selected youngsters of similar age and diabetes duration who had been intensively treated with insulin and served as a control group.
A1C tests and total daily insulin use from diagnosis to six months after infusion were compared. (A1C is a measure of blood glucose control over a two- to three-month period.) The children who received cord blood transfusions had lower average A1Cs, i.e. 7% vs. 8.04% in the intensively treated control group receiving insulin therapy alone. Children who had cord blood transfusions also required much lower average total daily insulin than the control group, 0.45 vs. 0.69 units of insulin per kilogram per day, respectively.
Over the six-month period there was little change in the stimulated C-peptide values of the group, indicating that they may have had retention of endogenous insulin production longer than expected for young children.
"The interim data from this small trial of the use of cord blood in recently diagnosed children with type 1 diabetes is encouraging and opens up new lines of investigation to understand the mechanism of the potential effects observed,"said Dr. Richard Insel, Executive Vice President for Research at JDRF.
This first use of cord blood in diabetes will help researchers focus on the specific cord blood cells that yielded the benefit. The researchers then hope to isolate and grow that cell type to develop therapies for a larger pool of people, not just those who have stored cord blood.
While this study does not confirm a specific advantage for any particular type of cell therapy, it argues strongly in favor of expanded studies to better characterize any source of regulatory T cells (also known as T regs) that may eventually be used in type 1 diabetes.
The researchers cautioned that it would be costly and inefficient for everyone to save their cord blood as a possible type 1 therapy. Therefore, the goal is to determine the factor in the cord blood that is yielding the benefit.
For detailed information about this study, view its abstract on the JDRF website: http://onlineapps.jdfcure.org/AbstractReport.cfm?grant_id=21211&abs_type=LAY
Read JDRF's Statement on Umbilical Cord Blood Research.
Get information about enrollment in the ongoing clinical trial.
View JDRF's webcast of Dr. Schatz's recent presentation on umbilical cord blood.
[http://www.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=6454E239-110A-9BB5-F860BAD2CB7813FC
New York, NY, June 25, 2007]
Mothers keep on giving…Stem cells, that is.
We have further proof of yet another naturally occuring adult stem cell line that contributes to treatment of diabetes in the recipient long after introduction of the cells and without immune rejection.
Scientists have reported in the "Proceedings of the National Academies of Science (Free abstract) about the discovery that mother's stem cells may cross the placenta and that- in those babies who grow up and later develop Type I diabetes ("Juvenile Diabetes," or "Insulin Dependent Diabetes Mellitis") – some of those cells help repair the pancreas and make insulin.
The researchers thought they would find evidence that the maternal cells might actually cause the diabetes, but instead found that the maternal cells had become beta islet cells of the pancreas, the cells which produce insulin, and were functioning in a beneficial way, years later.
From the online journal, ScienceDaily,
For the first time, scientists have discovered that cells passed from mother to child during pregnancy can differentiate into functioning islet beta cells that produce insulin in the child. The same study also found that maternal DNA was found in greater amounts in the blood of children and young adults with Type 1 diabetes than their healthy siblings and a control group, implying that they may be attempting to repair damaged tissue.
The findings suggest a beneficial role for this type of maternal microchimerism. Microchimerism is the term used when an individual harbors cells or DNA that originate from another genetically distinct individual.
In this study, published in the Jan. 22 issue of the Proceedings of the National Academy of Sciences, J. Lee Nelson, M.D., a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, and colleagues found no evidence that the mother's cells were attacking the child's insulin cells and no evidence that the maternal cells were targets of an immune response from the child's immune system.
"We think the maternal cells may be helping to regenerate damaged tissue in the pancreas," Nelson said.
She said investigators are excited about new possible approaches to treat Type 1 diabetes raised by their findings. For example, if maternal microchimerism results in cells that make insulin, a mother's stem cells might be harvested and used to treat her diabetic child. Such cells would have a genetic edge over donated islet cells from a cadaver that are usually completely genetically mismatched.
"The child is probably tolerant to the mother's half-matched cells because the child acquired the cells during its life as a fetus while its immune system was still developing," Nelson said.
Originally, the study of 172 individuals and pancreatic tissue from four males was designed to ask the question whether these small numbers of maternal cells might be involved in any way in Type 1 diabetes. "My initial theory was that perhaps, in some situations, too many mother cells cross over to the fetus at the wrong time, becoming beta cells that make insulin in the child. Could diabetes result because the child lost tolerance to those cells because they are genetically half foreign? Our research disproved this," she said.
Instead, the researchers found a small number of female islet beta cells in male pancreatic tissue (procured from autopsies) that produced insulin. "To our knowledge a maternal contribution to endocrine function has not previously been described," the authors said. "Our findings also raise the possibility that naturally acquired microchimerism might be exploited to therapeutic benefit."
The study found significantly higher levels of maternal DNA in the peripheral blood of 94 children and adults with Type 1 diabetes as compared to 54 unaffected siblings and 24 unrelated healthy subjects they studied. Maternal microchimerism first was recognized in children with severe combined immunodeficiency in the 1970s. In 1999, a study by Nelson et al was first to show that maternal microchimerism persists into adulthood for persons with uncompromised immune systems (Journal of Clinical Investigation 104:41-47).
Researchers in the UK also contributed to the report. From the BBC:
Jo Brodie, of the charity Diabetes UK, said scientists trying to perfect islet cell transplantation as a treatment for diabetes faced problems sourcing enough material, and preventing the recipients' immune systems from attacking the newly transplanted cells.
"If cells with the potential to produce insulin can pass from mother to child during pregnancy, without the child's immune system destroying them as seems to be the case here, then this could open up promising new avenues of research, and perhaps provide a new source of insulin-producing cells for therapeutic use."
[That 1999 article is available free online at PubMed Central: "Microchimerism of maternal origin persists into adult life." Maloney S, Smith A, Furst DE, Myerson D, Rupert K, Evans PC, Nelson JL.J Clin Invest. 1999 Jul 1; 104(1): 41-47.PMCID: 408407.]
Where did the stem cells come from in the mother? How are they preserved in the child through the years, even when mom and child would not be considered a good "tissue match" for organ donation? And how are they stimulated and recruited to the necessary tissues and organs in order to contribute to the repair and function of the child's tissues? How can we mimic and maximize the process when and where we want?
All of these questions are fertile ground for research. And not a one of the answers will depend on the destruction of a human being.
There's coverage in the January 22 Washington Post. However, the article states that Type I diabetes is inherited. The tendency may be inherited, but I don't believe that anyone has determined the actual gene or any specific trigger that can be said to cause Type 1 diabetes, other than the patiint's own immune system begins to make antibodies against the beta islet cells and insulin. Somehow, the mother's cells aren't affected in this case – which makes the discovery even more important and hopeful for patients: there has always been the concern that any new stem cells introduced into the patient would also be subjected to attack.
More information on Type 1 diabetes at E-Medicine.com (a very reliable site for medical information – http://www.emedicine.com/med/topic546.htm) and from The American Academy of Family Physcians. That last link is courtesy of the Post.
Labels: bioethics, medicine, research, stem cells
posted by LifeEthics.org at 1/24/2007
[http://www.lifeethics.org/www.lifeethics.org/2007/01/mothers-keep-on-giving.html
Wednesday, January 24, 2007 ]