Adult Stem Cells Continue to Show Promise for Diabetes Research and Therapy

Stem cell research is a promising component of what we hope will bring about a cure-like therapy for diabetes.  It may also provide models that enable the unraveling of Type 1 Diabetes and the mechanisms that bring about an auto-immune attack on islet cells.

We understand the ethical problems with destroying and harvesting an immature human in support of embryonic stem cell research. In addition, ESCR carries with it other challenges that have signifantly limited practical success including rejection and the potential for unpredictable growth.

Adult stem cells, derived from the same person they will be used to eventually treat, may enable the growth of insulin-producing cells, which could be used to repair the imcomplete pancreas.  Alok Jha, writing for the Observer, has an excellent piece that details the advantage that reprogrammed adult stem cells have:

Key to this is the discovery, in the past few years, of a way to make stem cells that do not require the destruction of embryos. In one move, these induced pluripotent stem (iPS) cells remove the ethical roadblocks faced by embryonic stem cells and, because they are so much easier to make, give scientists an inexhaustible supply of material, bringing them ever closer to those hoped-for treatments.

(…)

In 2007, Shinya Yamanaka at Kyoto University in Japan demonstrated a way of producing ES-like cells without using eggs. He took a skin cell and, using a virus, inserted four specific bits of DNA into the skin cell’s nucleus. The skin cell incorporated the genetic material and was regressed into an ES-like cell – it had been “reprogrammed” using a batch of chemicals in the lab. In a few short experiments, scientists had a near-limitless supply of stem cells that were, seemingly, as good as ES cells for their research.

As I mentioned earlier, one of the key applications for these cells is the development of models to study disease states:

Models using iPS cells have proliferated in a few short years: they are now available for, among other things, motor neurone disease, juvenile diabetes and sickle cell anaemia.

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The Cure – devices, transplants, stem cells and stopping beta cell attackers

I’m a proud techno-geek.  As a result, when I think about diabetes I tend to gravitate to technology oriented device solutions.  An Artificial Pancreas, a non-invasive blood glucose meter and interchangeable/inter-operable pumps and meters.

And, I like data, lots of data.

While technology is very important, the holy grail of diabetes research is not the future medical device with Star Trek capability unless it is able to promote and bring about a cure.

Pancreas and islet transplants have benefit individuals but have not yet provided a treatment that is worth the risk for most individuals.  And, even if the risks were mitigated, the lack of suitable donors is another impediment.

To me, the ideal is the development of implantable islets from adult stem cells take from the same individual who will receive them.  Rejection of the islets would be minimized and the us of immunosuppressive drugs, I would guess, could be minimize.  In short, Autologous Stem Cell Therapy Transplant requiring no immunosuppression

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A Stem Cell Treatment for Diabetes

A clinical study demonstrates that effectiveness of a new stem cell treatment for juvenile diabetes:

Children with type 1 diabetes can have the severity of their disease reduced if they are infused with blood saved from their umbilical cords, a study has found. Scientists think the infusion resets the body’s immune system, stopping it from destroying insulin-producing cells that are needed to control blood sugar levels.
“After only six months it is too early to tell 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 Haller of the University of Florida College of Medicine, who led the new research.

Note that the method uses the child’s own stem cells – not those extracted from an embryo. This decreases the risk of the treatment while overcoming the ethical concern associated with destroying a human life. Here’s more:

“The patients who received autologous cord blood infusions had better glycemic control, as evidenced by lower HbA1c, and that was statistically significant, and we also saw that they had lower insulin requirements compared with controls, also statistically significant,” said Dr. Haller.
Co-author Desmond A. Schatz, M.D., also at the University of Florida, commented that “this is really the first cellular therapy in which we’re taking one’s own cells that are naïve to the potential environmental insult that triggers this disease.”
[snip]
The investigators used unpaired t-tests to compare HbA1c and total daily insulin use between the groups from diagnosis to six months after infusion.
They found that the children who received cord blood infusions had lower average HbA1c levels at six months compared with controls, at 7.0% +1.77% for the infusion group over 28 total measurements, versus 8.04% + 0.8 over 108 measurements for controls (P=0.0031).
Insulin requirements in the children who received cord blood were also lower, with an average daily total of 0.45 + 0.23 U/kg compared with 0.69 + 0.24 for controls (P<0.0001).
A comparison of endogenous insulin function pre- and post-infusion also suggested that beta-cell function was preserved by the treatment. Three months after infusion, the average maximal stimulated C-peptide values increased in children who received cord blood, from 1.8 ng/ml prior to infusion, 1.9 ng/ml at three months, and a gradual fall to 1.39 ng/ml six months after infusion.

Even if the therapy proves its worth, it will likely be available only those who can afford the costs of collection of cord blood, which range from about $1,000 to $2,500, plus annual storage fees of $75 to $250.

Stem Cell Treatment for Diabetes?

Another study has been published showing that adult stem cell research has just as much potential, if not more, than embryonic stem cells to help patients with various diseases. In this cases, researchers at University of Florida founds that stem cells from umbilical cord blood helped children newly diagnosed with type 1 diabetes.
The study found that stem cell transfusions using the adult stem cells helped the children reduce their disease severity, possibly re-setting the immune system and slowing the destruction of their insulin-producing cells.
Michael J. Haller, MD, a professor at the University of Florida College of Medicine and lead author of the study, presented the findings at the American Diabetes Association’s 67th Annual Scientific Sessions.
“After only six months, it is too early to tell how long the children will benefit from this therapy, but early signs indicate that it may have helped enhance blood glucose control and management,” Dr. Haller said in a statement.
“But more important than the potential benefit in these children, this first use of cord blood in diabetes will help us focus on what it is in the cord blood that yielded the benefit,” he said. “We 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.”
Read the rest

Curing Diabetes with Stem Cells?

Researchers at the University of Texas Medical Branch at Galveston have revealed a fundamental break-through that may help cure Type 1 Diabetes. The medical technology, based upon adult stem cell research, enables people to grown their own insulin-producing cells, which could be used to repair the diseased pancreas.
The findings were announced in the June 2007 medical journal Cell Proliferation in a paper titled “the first demonstration that human umbilical cord blood-derived stem cells can be engineered” to synthesize insulin.
I note that the method is not based upon the destruction of embryos and is therefore not subject to the same moral scrutinity that ESC suffers. In addition, it looks like these results are extremely promising.
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Stem Cell Treatment for Diabetes

No, it hasn’t been rigorously tested, but adult stem cells are reportedly being used in Brazil to treat diabetes:

Thirteen young diabetics in Brazil have ditched their insulin shots and need no other medication thanks to a risky, but promising treatment with their own stem cells – apparently the first time such a feat has been accomplished.
Though too early to call it a cure, the procedure has enabled the young people, who have Type I diabetes, to live insulin-free so far, some as long as three years. The treatment involves stem cell transplants from the patients’ own blood.
“It’s the first time in the history of Type 1 diabetes where people have gone with no treatment whatsoever … no medications at all, with normal blood sugars,” said study co-author Dr. Richard Burt of Northwestern University’s medical school in Chicago.

Note that the study is small and treatment was applied to young persons with Type I.
The research was done in Brazil because U.S. doctors were not interested in the approach.

Successful Stem Cell Research for Diabetes Treatment

Researchers continue to make substantive progress toward the application of adult stem cells to diabetes treatment. Unlike embryonic stem cell research, the therapies are more than a conjecture – they are reported with concrete clinical evidence. In addition, adult stem cell applications do not involve the destruction of a human embryo.
Here are seven recent reports from the Coalition of Americans for Research Ethics (stemcellresearch.org):

  1. Stem cells may help Bergen boy fight diabetes,” NorthJersey.com (North Jersey Media Group Inc.), August 18, 2006
  2. International Trial of the Edmonton Protocol for Islet Transplantation,” New England Journal of Medicine, September 28, 2006
  3. Insulin Stem Cells Hold Hope for Diabetes Treatment,” Forbes, November 7, 2006
  4. Multipotent stromal cells from human marrow home to and promote repair of pancreatic islets andrenal glomeruli in diabetic NOD scid mice,” Proceedings of the National Academy of Sciences(PNAS), November 14, 2006
  5. AmCyte Presents Promising Adult Stem Cell Data at 7th Annual Rachmiel Levine Diabetes and Obesity Symposium,” Genetic Engineering News, November 9, 2006
  6. Researchers Make Stem Cell Breakthrough,” The Korea Times, January 23, 2007
  7. Diabetes repair ‘occurs in womb’,” BBC News, January 23, 2007

Again, these are very recent reports and a handful among many more.

Will Cloning Cure Diabetes?

When Governor Chet Culver recently declared that “it’s really up to the 100 state representatives now to decide if they want to give hope and opportunity to tens of thousands of people” he surrounded himself with children who have juvenile diabetes and proposed embryonic stem cell research and cloning as pathway to cure diabetes.
What the Governor failed to say and what the parents of these children apparently do not know is that even the most vigorous proponents of human cloning for research purposes, such as Ian Wilmut (head of the team that created Dolly), admit that stem cells from cloned embryos will not treat juvenile diabetes.

Justifying Embryonic Stem Cell Research

Plenty of lawmakers have a personal stake in the debate over stem cell research – a sick child hoping for a cure, a parent suffering from Alzheimer’s, a friend with diabetes. (Illinois Senate approves research on embryonic stem cells)
Sen. Linda Holmes: It’s extremely personal, and I think it has to be extremely personal for most of us
Sen. Chris Lauzen (Aurora) brings some sanity to the issue. “Obviously we all want cures to diseases,” He said. “The question is, what are willing to sacrifice to get them?”
He’s right. I might benefit immensely from a therapeutic treatment that is developed by killing human embryos but how does that justify the research or establish the morality of the action? I know my position is not popular, especially since the media has hyped ESC into a virtual certainty despite the obvious and well documented challenges. Yet, the purposeful destruction of a human cannot be accepted as either moral or logical on the basis of a potential and speculative “cure” (where have we heard hype over a “cure” before?).

Stem Cell Innovations Produces Human Pluripotent Stem Cells

PluripotentStemCells.jpeg

Pluripotent stem cells are cells that can produce additional stem cells as well as one or more other types of cells, and can develop into most, if not all, of the tissues of the organism. To date, two types of mammalian stem cells have been shown to be truly pluripotent: the well-known embryonic stem cells, which are cultured from very early embryos and are patented by the University of Wisconsin, and the lesser-known embryonic germ cells, which are developed from fetal gonadal tissue. Pluripotent stem cells hold great promise for both research and health care. This advance in human biology continues to generate enthusiasm among scientists, patients suffering from a broad range of diseases, including cancer, heart disease and diabetes, and their families.
Today, GEN is reporting that Dr. James H. Kelly, Chief Executive Officer of Stem Cell Innovations, Inc., will be presenting data at the Keystone Symposium on Stem Cells in Vancouver demonstrating that the Company has produced multiple lines of human pluripotent stem cells. Because these cells are derived from fetal tissue, not early embryos, they are eligible for use in laboratories funded by the National Institutes of Health.
In his presentation at the Symposium, Dr. Kelly will present data demonstrating that Company scientists were able to overcome many of the problems inherent in the production of EG cells. First, the Company’s cell lines are able to maintain their undifferentiated state and normal chromosome complement. Second, the Company is able to produce its cell lines without feeder layers (layers of foreign cells used as an environment to grow the stem cells which can complicate the process and result in contamination of the stem cells). Finally, the Company is able to efficiently develop multiple lines, the first step in creating banks of cells that can be matched to patients in cell therapies.

According to Dr. Kelly, the Company is considering ways in which to make these cells widely available to scientists and believes that these cells can make a significant contribution to our further understanding of stem cell biology and its accelerated commercial development.

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The Angel Lai Story: From Deaths’s Door To A Normal Four-year-old

With world news media focused on violence, disasters, conflict and other similar “newsworthy” events, it’s always nice to hear of a meaningful and heartwarming story that almost every family can identify with – the survival of a child against certain death. Even better, when it involves a life-saving medical procedure.
When Angel Lai was just six month’s old her health was going downhill fast with advanced leukaemia that had taken her little body to death’s door in less than a month. In fact, doctors had given her less than a 10 per cent chance of survival. At the time, her frantic parents were on the verge of loosing their only daughter.
Then two things happened that would eventually save Angel’s life: Her mom conceived a second child; and, a doctor told her mom about cord blood stem cell transplants.
Today, little four-year-old Angel Lai, a child whose doctors only gave a 10% chance of survival, is now a healthy, happy little girl, thanks to a stem cell donation from her baby brother.

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Adult Stem Cell Progress Mitigates Islet Transplant Challenge

We have closely followed the research involving the transplantation of insulin-producing islets from one individual into another, hoping for a long-term and effective treatment beyond medical devices, insulin injections and medication. Although the results have been encouraging, there are a number of significant challenges that have tempered our expectations. In fact, while several hundred patients have achieved at least temporary insulin independence after receiving the islet “mini-organs” (containing insulin-producing beta cells), very few patients remain insulin independent beyond 4 years after transplantation.
On problem, in particular is that the use of conventional immunosuppressants is not feasible because of long-term side effects. Transplant recipients need to take immunosuppressive drugs that stop the immune system from rejecting the transplanted islets and, even when used, rejection remains the biggest problem. The immune system is programmed to destroy bacteria, viruses, and tissue it recognizes as “foreign,” including transplanted islets. Immunosuppressive drugs are needed to keep the transplanted islets functioning. (more here)

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ADA Supports Cloning

… for the purpose of harvesting stem cell from human embryos. The position puts the organization at odds with the pro-life community.

Stem Cell Treatment for Peripheral Vascular Disease

Revascularization is one of the things that stem cell therapy can do to damaged areas of the heart. But what about other areas of the body? People suffering from Peripheral Vascular Disease (PVD) are at risk of losing limbs due a reduced (or ceased) blood-flow to their extremities.
TheraVitae, Ltd has announced plans to initiate clinical trials to treat Peripheral Vascular Disease using its latest generation of stem cell technology involving autologous adult stem cells. The trials are slated for November 2005 and will be held in conjunction with the Vascular Centers at both Chaophya Hospital and Bangkok Hospital.

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Stem Cell Research and Diabetes

stem_cells.jpgThe Plureon Corporation has entered into an agreement with BD (Becton, Dickinson and Company) in the field of diabetes research and development using Plureon’s platform stem cell technology. This is great news for individuals with diabetes because it puts the resources of a huge company behind the novel and promising technology that has shown feasibility in a number of applications.
Plureon’s stem cells are obtained from placental tissues that are usually discarded as medical waste after birth. These stem cells (“Plureon Stem Cells” or “PSCs”) have been differentiated into cells of all three germ layers, including bone, skeletal muscle, cardiac muscle, liver, nerve, fat, and pancreatic cells.
Unlike human embryonic stem, PSCs are not cancer-forming and do not involve the destruction of a human embryo. Since PSCs are obtained without harm to an embryo or fetus, they do not give rise to the ethical controversies which surround embryonic stem cells and cloning. For the same reason, research and use of PSCs have not been restricted by laws limiting the funding for research of embryonic stem cells.

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Stem Cells for Diabetes

The following news release is another potential “cure” for diabetes involving stem cells. The research is young and involves the discovery of pancreatic stem cells in mice. This does not translate in a short-time frame to the activation or production of beta cells in humans with diabetes. Yet, it is encouraging the current advancements may produce effective therapies within a few decades.
August 23, 2004 – A University of Alberta diabetes researcher has helped uncover a possible new source of insulin for diabetics and a valuable clue in the treatment of neurological disorders.
Dr. Greg Korbutt, a member of the U of A research team that developed the Edmonton Protocol treatment for type 1 diabetes, was part of a research collaboration centred at the University of Toronto that discovered pancreatic stem cells in mice. The finding is important because researchers were able to produce both neurons and insulin-producing cells from the stem cells found in the pancreas.

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Diabetes and Stem Cells Research

Type I diabetes, commonly diagnosed during childhood, is a condition in which the body does not produce insulin. Insulin is a hormone that is used in the body to process glucose by transporting it from blood into cells. Consequently, the disease is marked by chronically high blood glucose levels that over time lead to other health problems such as retinopathy (and blindness), heart disease and neuropathy.

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