Tuesday, April 10, 2007

Type I diabetes cure? Maybe.....

The AP is reporting that a small and flawed, but intriguing study in Brazil has "cured" 13 out of 15 test subjects of Type I Diabetes. These subjects were given drugs to stimulate the production of stem cells in their blood, and then after the cells were harvested, the subjects were essentially given what is known as the "shake and bake" treatment, which is a round of chemotherapy used to destroy bone marrow, then the stem cells were re-introduced. The stem cells rebuilt the immune system in such a way as to halt the auto-immune attack on the islet cells. No islet cells were replaced however and they don't grow back. Therefore this arrested further destruction of the cells, but did not resurrect/replace any that have already been destroyed. That means early diagnosis is key to this procedure working. Well there is encouraging news on that front as well. As I posted some weeks back, researchers have found three antibodies that are present in at least 70%, and possibly as many as 90% of type I diabetics. It is believed that these antibodies appear long before symptoms do and are a marker for people who will develop diabetes in the future. If that is true, we may now finally have the tools to diagnose and treat people before they develop insulin dependence.

This is a very good thing.

UPDATE:, Dr. Beverly B. Nuckols, MD, of LifeEthics.Org in the comments kindly posted a link to the JAMA article which I updated the story above with. She has posted about it as well. From my reading of the abstract, it does not appear that the stem cells were modified at all. This would appear to be identical in every respect to the Autologous Bone Marrow Transplant procedure used to treat certain types of leukemia.

Additionally, there is an article in this month's Discover magazine (they don't have the article up on the net yet or I'd link to it.) that discusses the effect of microchimeraism on Type I diabetes. It has been discovered that we are all Chimeras. We all have maternal cells that have taken up residence in our own bodies during gestation and our immune system does not attack them. In diabetics that have had their pancreas removed at autopsy and studied, it was found that the remaining Beta cells were almost all maternal cells. This shows another path to treatment, Beta cell transplants from the patient's mother. Unfortunately, obtaining them from the patient's mother may push HER into Type I diabetes, but Dr. Michael German MD, at UCSF is currently working on how to tease stem cells into beta cells. If this works on adult stem cells, it may be possible to perform a beta cell transplant from the patient's mother that would be safe from the auto-immune attack.