FRIDAY, July 14, 2017 -- A treatment targeting wayward immune cells in people with type 1 or type 2 diabetes may help even years later, a new study finds.
For the treatment, researchers take blood from a person with diabetes and separate out the immune system cells (lymphocytes). They briefly expose those cells to stem cells from umbilical cord blood from an unrelated infant. Then they return the lymphocytes to the patient's body.
The researchers have dubbed this treatment "stem cell educator therapy," because when exposed to the stem cells, the errant lymphocytes seem to re-learn how they should behave.
"Stem cell educator therapy is a safe approach" with long-term effectiveness, said the study's lead author, Dr. Yong Zhao. He's an associate scientist at Hackensack University Medical Center in New Jersey.
Type 1 diabetes, an autoimmune disease, occurs when the body's immune system cells mistakenly attack the insulin-producing, or beta, cells in the pancreas. This leaves people with type 1 diabetes with little to no insulin. They need insulin injections to survive.
Researchers have long thought that any cure for type 1 diabetes would have to stop the autoimmune attack, while regenerating or transplanting beta cells.
But Zhao and his team developed a new approach to the problem -- educating the immune cells that had been destroying beta cells so they stop attacking.
In type 2 diabetes, Zhao said immune cell dysfunction is responsible for chronic inflammation that causes insulin resistance. When someone is insulin resistant, their body's cells can't properly use insulin to usher sugar from foods into cells for use as energy. Instead, the sugar builds up in the blood.
The researchers hoped the stem cell educator would help decrease insulin resistance for people with type 2 diabetes.
In earlier trials, the treatment showed significant promise with up to a year of data. The researchers also showed that the treatment was safe.
The current study looked at four years of data on nine type 1 diabetes patients in China.
To see how well the treatment works, the researchers measured C-peptide, a protein fragment that's a byproduct of insulin production.
Two people with type 1 diabetes who received a stem cell educator treatment shortly after diagnosis (five and eight months later) still had normal C-peptide production and didn't need insulin four years after a single treatment.
Another type 1 patient had had the disease for four years when she got a treatment. She still had improvements in her C-peptide levels, but wasn't considered in remission. The remaining six people with type 1 saw decreases in their C-peptide levels over time. The study authors said this suggests more than one treatment might be needed.
"Because this was a first trial, patients just got one treatment. Now we know it's very safe so patients can receive two or three treatments," Zhao said.
Researchers also looked at six patients with severe, long-standing -- 15-24 years -- type 2 diabetes. They found that one treatment helped four patients achieve normal C-peptide levels and maintain them over the four-year follow-up.
"For the four type 2 patients, their C-peptide is very stable after one treatment," Zhao said.
In addition to helping people with diabetes, Zhao said the treatment could help with other autoimmune diseases, too. These might include alopecia areata, which causes significant and sudden hair loss; lupus, Hashimoto's thyroiditis; and Sjogren's syndrome, he said.
Julia Greenstein is vice president of discovery research at JDRF, formerly the Juvenile Diabetes Research Foundation. She said Zhao and his team have shown that the "platelets seem to be having a direct effect on the beta cells," boosting the beta cells somehow.
"This research is intriguing, but it needs to be reproduced," she said.
Both Zhao and Greenstein noted that diabetes seems to differ slightly in Chinese populations from Western ones. So, it's not yet clear if this treatment would be as beneficial for people of European descent.
To find out, Zhao plans to conduct a clinical trial of the new treatment with people with type 1 diabetes at Hackensack Medical Center.
The study was recently published in Stem Cells Translational Medicine.
Learn more about type 1 diabetes from JDRF.
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