Novel strategies for treating patients having type 1 diabetes are being explored. In one of the recent findings, a therapy using stem cells seems to re-educate abnormal immune system cells, allowing the pancreas to synthesize insulin again. This newly developed technique combines patient’s immune system cells with donor’s cord blood stem cells and appears to work in patients with chronic diabetes as well.The average blood sugar levels of patients subjected to this therapy, dropped significantly, reducing the risk of long-term complications; but nevertheless, complete discontinuation of external insulin was not possible for any of them.

Dr. Yong Zhao, an assistant professor in the section of endocrinology, diabetes and metabolism at the University of Illinois at Chicago, said “Our study brings a new hope for people with type 1 diabetes. If we can control the autoimmunity, we may reverse the diabetes. We showed that the islets 1/8cells3/8 can start to work again”.

Another researcher Dr. Luca Inverardi, deputy director of translational research at the Diabetes Research Institute, University of Miami School of Medicine, commented, “It’s quite remarkable that this approach, based on the re-education of immune cells, might work so well. The concept is very intriguing, and the treatment seems to be so simple and so safe”. He added further, “The follow-up is long, up to 40 weeks, but it’s not long enough to declare victory against diabetes yet.”

As the responses can vary with the type of population, Dr.Inveradi also pointed out that a larger study with diverse people and following up thereon, can help gain more insights into the potential that this therapy has.

The strategy that Zhao’s team developed involved taking blood from a patient and separating out the immune system cells (lymphocytes). Further, briefly exposing these cells to stem cells derived from umbilical cord blood – from an unrelated infant and then, returning the lymphocytes alone to the patient’s body. The procedure is being addressed by researchers as – “Stem Cell Educator Therapy,” because while exposed to the stem cells, the lymphocytes seem to relearn how they should behave.

The study participants, all in the 15 – 41 age group; suffered from type 1 diabetes for an average of nine years. Six of them had some residual beta cell function while six others did not. Both of the groups were subjected to stem cell educator therapy. The remaining three individuals served as the control group.

The researchers quantified C-peptide, a protein fragment that is a byproduct of insulin production, and found that the educator therapy group had enhanced levels of C-peptide at 12 weeks. These levels continued to grow until 24 weeks, and remained stable through the follow-up at 40 weeks. However, no changes were observed in C-peptide in the control group.

The average daily required dose of insulin dropped almost 39 percent after 12 weeks for the group with some beta cell function and 25 percent in those with no beta cell function, suggesting that the group with no beta cell function now synthesized insulin.

In view of these findings, Dr. Inveradi said, “That means if you stop the autoimmune reaction, you may see beta cell regeneration, or there might be other precursor cells in the pancreas. If these data are confirmed, this is a very provocative and remarkable finding.”

Zhao said that in future trials he hopes that with additional treatments people might not require external insulin altogether. Nevertheless, even if that is not possible, the recovery of some beta cell function would be something well received.

Further, both experts said the treatment appears safe, with no risk of rejection; and that no significant side effects were reported during the trial, other than some arm soreness where blood was taken and returned.

Findings of this study were published earlier this month in the journal BMC Medicine.

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