Umbilical cord blood may safely preserve insulin production in children newly diagnosed with type 1 diabetes, according to findings from a small national pilot study presented in June at the American Diabetes Association”s 67th Scientific Sessions in Chicago.
University of Florida researchers sought to determine whether it is feasible to use a patient”s own cord blood stem cells to neutralize the body”s autoimmune attack on the pancreas and help restore the organ”s ability to make insulin, which regulates how the body uses sugar and other nutrients for energy.
“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 pediatric endocrinologist Dr. Michael Haller, an assistant professor of medicine at UF”s College of Medicine.
“While this is a relatively small study we can confidently say this is safe, and we have seen metabolic and immunologic changes to suggest there may be benefit,’ Haller said. “It”s not curing diabetes, but this is a first step to help us learn more and get us moving in the right direction.’
Cord blood is rich with cells that help regulate the immune system but until now has typically been used to restore a patient”s immune system after treatments for leukemia or lymphoma.
UF researchers identified children recently diagnosed with type 1 diabetes whose families banked their umbilical cord blood at birth. Most were still producing a small amount of insulin. The researchers then gave seven patients ages 2 to 7 intravenous infusions of stem cells isolated from their own cord blood. (They have since treated an additional four children.) The patients were evaluated for the next two years to measure how much insulin they were making on their own and to assess blood sugar levels and the function of key immune system cells.
In the first six months, they required significantly less insulin — on average 0.45 versus 0.69 units of insulin per kilogram per day — and maintained better control of blood sugar levels than children of comparable age with type 1 diabetes who were randomly selected from the clinic population. The researchers also noted that the children who received cord blood infusions had higher levels of regulatory immune cells in their blood six months after the infusion, on average 9 percent of the total cell volume compared with 7.21 percent at the time of infusion.
“This isn”t a cure-all. We think that giving these cells is essentially providing some immunotherapy and downregulating the autoimmunity these patients have,’ Haller said. “Realistically, we hope to protect what”s left of their insulin-production for an extended period of time.’
The idea would be to intervene and repair any early damage during the “honeymoon period’ many patients enjoy — the first several months after diagnosis during which insulin needs are minimal, he added.
The Juvenile Diabetes Research Foundation and the National Institutes of Health funded the study, with support from UF”s Clinical Research Center.