Umbilical Cord Blood Alters Course of Type 1 Diabetes in Newly Diagnosed
June 25, 2007 -- Researchers supported by the Juvenile Diabetes Research Foundation have found that transfusion of stored umbilical cord blood into a small group of newly diagnosed children with type 1 diabetes appears to have delayed the progression of the disease, possibly re-setting the immune system and slowing the destruction of their insulin-producing cells.
Desmond A. Schatz, MD, Professor and Associate Chairman of Pediatrics at the University of Florida College of Medicine and senior author of the study, recruited seven young (age 2 to 7 years at the time of infusion) children with type 1 diabetes who had their own stored cord blood and infused them with it. This group was matched with 13 randomly selected youngsters of similar age and diabetes duration who had been intensively treated with insulin and served as a control group.
A1C tests and total daily insulin use from diagnosis to six months after infusion were compared. (A1C is a measure of blood glucose control over a two- to three-month period.) The children who received cord blood transfusions had lower average A1Cs, i.e. 7% vs. 8.04% in the intensively treated control group receiving insulin therapy alone. Children who had cord blood transfusions also required much lower average total daily insulin than the control group, 0.45 vs. 0.69 units of insulin per kilogram per day, respectively.
Over the six-month period there was little change in the stimulated C-peptide values of the group, indicating that they may have had retention of endogenous insulin production longer than expected for young children.
"The interim data from this small trial of the use of cord blood in recently diagnosed children with type 1 diabetes is encouraging and opens up new lines of investigation to understand the mechanism of the potential effects observed,"said Dr. Richard Insel, Executive Vice President for Research at JDRF.
This first use of cord blood in diabetes will help researchers focus on the specific cord blood cells that yielded the benefit. The researchers then hope to isolate and grow that cell type to develop therapies for a larger pool of people, not just those who have stored cord blood.
While this study does not confirm a specific advantage for any particular type of cell therapy, it argues strongly in favor of expanded studies to better characterize any source of regulatory T cells (also known as T regs) that may eventually be used in type 1 diabetes.
The researchers cautioned that it would be costly and inefficient for everyone to save their cord blood as a possible type 1 therapy. Therefore, the goal is to determine the factor in the cord blood that is yielding the benefit.
