CORD BLOOD FOR DIABETICS
REPORT: MB #2903
BACKGROUND: According to the Juvenile Diabetes Research Foundation, as many as three million Americans may be living with type 1 diabetes. Type 1 diabetes is usually diagnosed in children and young adults and was previously known as juvenile diabetes. The disease causes the body to stop producing insulin, a hormone that converts sugar, starches and other food into energy needed for daily life. The disease can lead to many complications including heart disease, kidney disease, blindness, nerve damage, foot complications and skin problems. Patients with type 1 diabetes must carefully monitor their blood sugar levels.
CURRENT THERAPIES: Current therapies for type 1 diabetes involve delivering insulin to the bloodstream. This can be done in a variety of ways. Patients can inject themselves with insulin, inhale the insulin or wear a pump that delivers the insulin to the bloodstream. The insulin does not cure the problem, but only momentarily fixes it. Patients must continue to take insulin for the rest of their lives.
UMBILICAL CORD BLOOD: Today, new parents have a choice when their child is born: they can either bank or discard their newborn's umbilical cord blood. After a baby is born and the umbilical cord is cut, some blood remains in the blood vessels of the placenta and the portion of the umbilical cord still attached to it. The cord blood contains all of the normal elements of blood: red blood cells, white blood cells, platelets and plasma; however, it is also rich in blood-forming stem cells similar to those found in bone marrow. Cord blood has been used on an experimental basis as a source of stem cells. Most cord blood transplants have been done to treat diseases of the blood and immune system. They have also been performed to restore the functional deficiencies of several genetic diseases. When families choose to store their baby's cord blood in a private bank, they pay a fee of up to $2,000 initially and then about $100 a year to store their baby's blood in a secure bank. The family has exclusive rights to the blood and can use it if needed. The cells are a perfect match for the baby, and sometimes the mother may also be able to use the cells since she carried the child during pregnancy.
A NEW USE FOR CORD BLOOD: Researchers from the University of Florida (UF) in Gainesville, Fla., are the first to experiment with cord blood infusions as a treatment for children with type 1 diabetes. The investigators received the idea in part from a patient's father who had read scientists elsewhere were able to reverse diabetes in mice by taking bone marrow from an animal and infusing it into its identical sibling without using chemotherapy or radiation. In the lab, scientists were able to coax stem cells from cord blood into making insulin. The man asked UF researchers whether giving a patient his or her own cord blood could have a similar effect. "I usually listen to everybody," Desmond Schatz, M.D., a pediatric endocrinologist at UF told Ivanhoe. "I think I keep an open mind."
THE STUDY: For the study, researchers identified children recently diagnosed with type 1 diabetes whose families had banked their cord blood at birth. Most of the participants were still producing a small amount of insulin. The researchers then gave patients intravenous infusions of stem cells isolated from their own cord blood. In the first six months, patients given the infusions required less insulin: on average, 0.45 versus 0.69 units of insulin per kilogram per day. The children also maintained better control of blood sugar levels than children of a comparable age with type 1 diabetes randomly selected from the clinic population. The researchers also found children who received cord blood infusions had higher levels of regulatory immune cells in their blood: on average, nine percent of the total cell volume compared with 7.21 percent at the time of the infusion. The experimental treatment is not a cure, but it is a significant step toward a better understanding of the disease. In the future, researchers hope they can intervene and repair early damage during the "honeymoon period" -- the first several months after diagnosis when insulin needs are minimal. They hope the cord blood treatment will eventually become part of a combination therapy approach to treating the disease. The study was funded by the Juvenile Diabetes Research Foundation and the National Institutes of Health.
FOR MORE INFORMATION, PLEASE CONTACT:
Michael Haller, MD, hallemj@peds.ufl.edu
Melanie Fridl Ross, PR, (532) 273-5812
http://www.ufl.edu
