Type 1 diabetes is a form of diabetes mellitus that is caused by the body’s own immune system attacking its pancreatic islet β cells. These cells would normally produce insulin, which regulates glucose metabolism. Therefore, type 1 diabetic patients require life-long daily insulin injections in order to avoid health complications such as atherosclerosis, neuropathy and kidney disease.
Affecting around 10% of all diabetes patients, type 1 diabetes is far less common than type 2 diabetes, but its incidence has doubled in the past 20 years. This, in combination with the current, often inconvenient management of type 1 diabetes, has led researchers to develop alternative treatment strategies.
A new method described in BMC Medicine uses stem cells from healthy donors’ cord blood to modulate the diabetic patients T cells to reverse auto-immunity towards pancreatic islet β cells. This involved use of a Stem Cell Educator device, which is a closed-loop system containing immobilized cord blood stem cells (CBSC) from healthy, non-diabetic donors. Lymphocytes separated from each diabetic patient’s blood were passed over these immobilized stem cells for a period of two to three hours. After the ‘re-education’ process, the lymphocytes were returned to the patient.This resulted in regeneration of islet β cells that were then able to produce insulin again, so that 12 weeks after treatment all the patients who received the therapy had improved β cell function. This continued to improve and was maintained to the end of the study. Interestingly, this also meant that the daily dose of insulin required to maintain patients’ blood glucose levels could be reduced.
These remarkable results may provide a new approach to overcome the autoimmunity underlying type 1 diabetes, and may have important implications for other autoimmune and inflammation-related diseases.
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