Study Says Stem Cells Could Remedy Diabetes in Long Term
A clinical trial conducted in Brazil comprising 21 adults patients with type 1 diabetes shows that a stem cell transplant may remedy the disease, at least for a number of years. Published recently in the journal Frontiers in Immunology, the results showed that most patients became insulin-free for three and a half years and one patient did not have to use insulin for eight years.
Bart Roep, Ph.D.
“We now understand stem cell transplants can succeed in treating diabetes for some,” said Bart Roep, Ph.D., the Chan Soon-Shiong Shapiro Distinguished Chair in Diabetes, professor/founding chair of the Department of Diabetes Immunology and monitor of the clinical trial.
These positive outcomes were not the rule. For some patients, the stem cell transplant had little to no effect on their type 1 diabetes (T1D).
“We discovered the immune signature predicting these outcomes—either favorable or not—which is the first step toward personalized medicine in type 1 diabetes,” said Dr. Roep. “Understanding why it sometimes fails will allow us to design new treatment strategies for those less fortunate patients. Also, it is the first definitive proof that T1D can be cured.”
In the study, the type 1 diabetes patients lasted up to 30 months after infusion without insulin; however, after that point in time, the benefits started to decrease and most of the long-lasting insulin-free patients eventually resumed insulin. This indicated that additional mechanisms may be at play or that genetic background may still have an influence. To counter this effect, T-regulatory cells (Tregs) were infused. In short-term follow-ups, infusions of Tregs decreased insulin requirements in six out of eight patients, two of which became insulin-free.
The stem cells in this study were autologous hematopoietic stem cells. They are the same type of stem cells found in umbilical cord blood. Because type 1 diabetes (often referred to as juvenile diabetes) is an auto-immune disease that shows up early in life, it is easy to see where the outcome of this study could prove beneficial to people whose cord blood was stored at birth. Cord blood is the best source of these hematopoietic stem cells because of their naïveté and lack of any mutations caused by ageing.
The results of this study follow a recent conclusion by the same researchers that type 1 diabetes was not caused by immune system mistakenly attacking insulin-creating beta cells but rather caused by distressed beta cells themselves effecting the immune response.