Infusions of stem cells taken from umbilical cord jelly helped people with newly diagnosed type 1 diabetes reduce their need for insulin injections in a small study.
Stem cells taken from babies’ umbilical cords can delay the progression of type 1 diabetes in other people, a small trial has shown.
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| A scanning electron micrograph showing mesenchymal stem cells, derived from an umbilical cord, that were grown in a gel culture EYE OF SCIENCE/SCIENCE PHOTO LIBRARY |
Type 1 diabetes usually begins in teenagers and young adults, when their immune system starts to mistakenly attack cells in the pancreas that make the hormone insulin, which regulates blood sugar. People with the condition therefore have to inject artificial insulin.
To explore the potential of stem cells in treating type 1 diabetes, Per-Ola Carlsson at Uppsala University, Sweden, and his colleagues infused 10 adults who had an early stage of the condition, diagnosed about a year ago, with “mesenchymal” stem cells sourced from the goo inside umbilical cords known as Wharton’s jelly. Five other people with type 1 diabetes received a placebo infusion.
Stem cells are similar to the cells in developing embryos, in that they can multiply and develop into different tissues. Several kinds of stem cells have been found in different parts of the body and they have varying properties, but mesenchymal stem cells seem to have a particular knack for dampening a harmful immune response. “They release a lot of chemical signals that modulate the patient’s immune system,” says Lindsay Davies at the firm Nextcell Pharma in Sweden, which is developing the Wharton jelly-based therapy.
Usually, people with newly diagnosed type 1 diabetes see their insulin production decline over several years, so they need increasing top-ups of artificial insulin. In the trial, those who got the stem cells had no change in their requirements for artificial insulin over the next 12 months, with these requirements increasing in the placebo group.
The researchers also measured the participants’ levels of C-peptide, a marker of how much natural insulin they make. In those who had the stem cells, C-peptide levels fell by 10 per cent after one year, compared with a fall of nearly 50 per cent in the placebo group.
As well as their immune-dampening properties, mesenchymal stem cells have the other advantage of potentially being used “off the shelf”, rather than having to be prepared specially for each recipient. That is because they lack molecules on their surface that would normally trigger an immune attack when cells or tissues from one person are transplanted into someone unrelated to them.
Stem cells of various kinds are a hot topic in medical research, although results so far have been mixed. For instance, there was initially hope they could become a treatment for heart attacks, but results from larger trials showed they don’t work for this.
Nextcell aims to get more consistent effects by taking mesenchymal stem cells from multiple umbilical cords and selecting only those that show the right immunological properties when tested in the lab, to make a therapy it calls ProTrans. For each batch, the researchers take stem cells from 30 babies’ umbilical cords and select those from the five most promising cords. This makes enough to treat up to 40 people with early-stage type 1 diabetes, says Davies.
Daniel Drucker at Sinai Health in Toronto, Canada, says the results are promising, but those who get the treatment will need to be monitored for many years to ensure the cells don’t trigger a harmful immune response. “It’s really encouraging, but one has to be extremely cautious with very small studies,” he says.
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