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Umbilical cord blood infusion may improve metabolic control in type 1 diabetes
Promising data suggest a potential treatment.
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CHICAGO – Autologous umbilical cord blood helped reduce the disease severity in seven children with newly diagnosed type 1 diabetes, suggesting a possible resetting of the immune system.
Preliminary, six-month data from a study have demonstrated that children who received an umbilical cord blood infusion had reductions in HbA1c, lower insulin requirements and preserved C-peptide values.
“It is too early to tell if, or for how long, the children will benefit from this therapy, but early signs indicate that it may have helped enhance blood glucose control and management,” said Michael J. Haller, MD, assistant professor of pediatric endocrinology, University of Florida College of Medicine. Haller presented these results at the American Diabetes Association 67th Annual Scientific Sessions.
“This first use of cord blood in diabetes will help us focus on what it is in the cord blood that potentially yielded the benefit,” he said.
Seven cord blood infusions
In the small study, seven children with type 1 diabetes (aged 2 to 7 years; duration of disease, 0.84 years) received an infusion of their own stored autologous umbilical cord blood. The researchers measured their HbA1c levels and total daily insulin use up to six months after infusion and compared it with data from 13 matched controls intensively treated with insulin.
The children who received cord blood infusions had lower levels of HbA1c (7% ± 1.77% vs. 8.04% ± 0.8%; P=.0031). The same children also required much lower average total daily insulin compared with the control group (0.45 U/kg ± 0.23 U/kg vs. 0.69 U/kg ± 0.24 U/kg per day; P<.0001). After six months, there was a preservation of C-peptide values; these children may have had retention of endogenous insulin production longer than expected for young children because of the umbilical cord blood infusion, according to the researchers.
There were no adverse events associated with the infusion.
Regulatory T cells
Current research is focused on the factor in the cord blood that is responsible for the beneficial effects. One possible mechanism of action may be through regulatory T cells, known to induce autoimmune tolerance and play a pivotal role in immune regulation, according to the researchers. Umbilical cord blood is an excellent source of regulatory T cells. Patients who received cord blood had an increase in regulatory T cells after six months.
It might be used as a cocktail therapy for use in combination with other immunosuppressive or immunomodulating drugs, “in a manner similar to the breakthroughs made in treating HIV and cancer,” according to Haller.
His colleague, Desmond A. Schatz, MD, professor and associate chairman of pediatrics, University of Florida College of Medicine, said, “although cord blood contains stem cells capable of differentiating into insulin-producing cells, and infused cells could have stimulated islets to regenerate, it is most likely that infused regulatory T cells, known to induce autoimmune tolerance, may have prompted a type of immune regulation.”
Further studies are underway to isolate and develop therapies for patients who do not only have stored cord blood. – by Katie Kalvaitis
For more information:
- Haller MJ, Viener H, Brusko T, et al. Insulin requirements, HbA1c and stimulated C-peptide following autologous umbilical cord transfusion in children with type 1 diabetes.
- Viener H, Brusko T, Wasser-Fall C, et al. Changes in regulatory T cells following autologous umbilical cord blood transfusion in children with type 1 diabetes.
- Both presented at: The American Diabetes Association 67th Annual Scientific Sessions; June 22-26, 2007; Chicago.