Reversal of type 1 diabetes via islet β cell regeneration
Reversal of type 1 diabetes via islet β cell regeneration following immune modulation by cord blood-derived multipotent stem cells
Research abstract published in BMC Medicine
Background
Inability to control autoimmunity is the primary barrier to developing a cure for type 1 diabetes (T1D). Evidence that human cord blood-derived multipotent stem cells (CB-SCs) can control autoimmune responses by altering regulatory T cells (Tregs) and human islet β cell-specific T cell clones offers promise for a new approach to overcome the autoimmunity underlying T1D.
Methods
We developed a procedure for Stem Cell Educator therapy in which a patient's blood is circulated through a closed-loop system that separates lymphocytes from the whole blood and briefly co-cultures them with adherent CB-SCs before returning them to the patient's circulation. In an open-label, phase1/phase 2 study, patients (n = 15) with T1D received one treatment with the Stem Cell Educator. Median age was 29 years (range: 15 to 41), and median diabetic history was 8 years (range: 1 to 21).
Results
Stem Cell Educator therapy was well tolerated in all participants with minimal pain from two venipunctures and no adverse events. Stem Cell Educator therapy can markedly improve C-peptide levels, reduce the median glycated hemoglobin A1C (HbA1C) values, and decrease the median daily dose of insulin in patients with some residual β cell function (n = 6) and patients with no residual pancreatic islet β cell function (n = 6). Treatment also produced an increase in basal and glucose-stimulated C-peptide levels through 40 weeks. However, participants in the Control Group (n = 3) did not exhibit significant change at any follow-up. Individuals who received Stem Cell Educator therapy exhibited increased expression of co-stimulating molecules (specifically, CD28 and ICOS), increases in the number of CD4+CD25+Foxp3+ Tregs, and restoration of Th1/Th2/Th3 cytokine balance.
Conclusions
Stem Cell Educator therapy is safe, and in individuals with moderate or severe T1D, a single treatment produces lasting improvement in metabolic control. Initial results indicate Stem Cell Educator therapy reverses autoimmunity and promotes regeneration of islet β cells. Successful immune modulation by CB-SCs and the resulting clinical improvement in patient status may have important implications for other autoimmune and inflammation-related diseases without the safety and ethical concerns associated with conventional stem cell-based approaches.
Trial registration
ClinicalTrials.gov number, NCT01350219.
Tags: autoimmune, autoimmunity, beta cell, cure, islet, mellitus, research, stem cell, t1d, type 1
Replies to This Discussion
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Permalink Reply by Brunetta on -
Thanks for this post, Emily. I think that this research, thpugh the study group was limited is a further indicator that medical interventions in the future for Type one diabetes and ,other autoimmune disorders, WILL be morer will yield positive reuslts. I do expect there will be a "cure", or close to it, in my lifetime. And I am 57 with type one for 43 years..... I truly believe that our bodies can heal themselves, we were made that way....but we just do not know how, YET.
God bless,
Brunetta
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Permalink Reply by Dean Phillips on -
I agree that the body is designed to heal itself and we just haven't figured out the how, yet. I wonder if anyone with T1, anyone else I mean, is trying to figure this out on their own?
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Permalink Reply by Kim on
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Lasting improvement is vague. I wonder if any the recipients were actually off injected insulin for some time?
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Permalink Reply by Capin101 on
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Very novel study with some interesting ideas. First, please note that it originates from communist China's military and the universtiy of Illini is a collaborator.
I would guess that the remission of autoimmune attack on insulin producing cells is finite. Like A1c, when new T cells are produced, the onslaught on beta cells will begin again. One year in length if we are lucky and then the subjects would need the procedure again.
More importantly, modifying T cells may have unknown and very dangerous consequences. T cells have many other duties besides attacking out beta cells. Mainly illiciting an immune response to infections and reviewing host tissues "health". These subjects may easily be increasing their risk for infections and cancers that T cells may stop before they get started.
A very novel idea that is worth pursuing, but with reservations. A long term follow up to determine the effects of such a new idea are needed before an idea like this can even be considered for the general T1 population.
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Permalink Reply by Gary on -
I've corresponded with the lead researcher in this study in a brief email. I was not able to obtain really any info from him other then what was published in that article which is now a few months old already. He noted they were working towards filing an IND in the US and hopefully getting the go ahead in the near future, I don't think any of the patients in the trial were able to get off insulin but all patients were able to reduce insulin dosage significantly which is pretty impressive. I won't get over excited about this just yet but the results speak for themselves.
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Permalink Reply by Bryan Acosta on -
This method of rehabilitating the T-cells is amazing. However, the root cause of the T-cells corrupting to begin with is unknown.
This makes me wonder if reactivating the bodies own thymus would also have similar effect. The thymus destroys T-cells that have corrupted but the thymus seizes to function at the onset of puberty. Could added hormones in the food trigger an early termination of the thymus?
They are on the right track anyway.
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