The old paradigm was, “Diabetes type 1 is an irreversible short-term autoimmune disease that destroys all of the insulin-producing cells in the pancreas.”[1] However, Dr. Neil H. Riordan has proposed a new paradigm, “Diabetes type 1 is a chronic autoimmune disease that, when corrected, allows the insulin-producing cells of the pancreas to regenerate.” In 2010, researchers injected type-1 diabetic mice in the abdomen with pig Sertoli cells.[2] Sertoli cells are similar to stem cells and are oftentimes called nurse cells because they nourish and protect other cells. Although Sertoli cells do not secrete insulin, 81% of the diabetic mice became non-diabetic from a single injection.[3] The reason the mice became non-diabetic was the Sertoli cells secreted immune-modulating molecules and the damaged pancreatic cells were able to regenerate. The regenerated pancreatic cells made all the insulin the mice needed to be healthy.
Typically, tissues and organs that are transplanted from one person to another require life-long immunosuppressive therapy with drugs or surgery.[4] Otherwise, your immune system will recognize that the newly introduced tissue is not your own and will attack it. Stem cells have a special ability to calm the immune system and reduce inflammation, especially placenta and umbilical stem cells.[5] The rationale of using stem cells for type 1 diabetes is because of these special immune privileges. Clinical trials investigating stem cells for type 1 diabetes have been conducted since 2005.[6] Collectively, these studies demonstrate that stem cell therapy can improve insulin production, laboratory parameters and chronic complications of diabetes.[7] In addition, stem cell treatment has made 20 to 60% of type 1 diabetic patients insulin-free depending on the type of stem cells used for periods as long as 12 to 24 months.[8] Administration of stem cells early after type 1 diabetes diagnosis was more effective than treatment at later stages. Thus far studies conclude, stem cell therapy has been shown to be safe and generally considered cost-effective. Ongoing clinical trials are being carried out for type 1 diabetes to determine the efficacy of different doses, stem cell mobilizers and stem cell sources including placenta and umbilical tissues.[9-12]

References

  1. Riordan, N.H., Stem Cell Therapy: A Rising Tide: How Stem Cells Are Disrupting Medicine and Transforming Lives. 2017: Neil H Riordan.
  2. Luca, G., et al., Xenograft of microencapsulated sertoli cells reverses T1DM in NOD mice by inducing neogenesis of beta-cells. Transplantation, 2010. 90(12): p. 1352-1357.
  3. Mital, P., G. Kaur, and J.M. Dufour, Immunoprotective sertoli cells: making allogeneic and xenogeneic transplantation feasible. Reproduction, 2010. 139(3): p. 495-504.
  4. Medscape. Immunosuppression: Overview. 1/4/2016 [Date Accessed: 1/2018]; Available from: https://emedicine.medscape.com/article/432316-overview.
  5. Lovell, T.M., et al., Identification of a novel mammalian post-translational modification, phosphocholine, on placental secretory polypeptides. J Mol Endocrinol, 2007. 39(3): p. 189-98.
  6. Lock, L.T. and E.S. Tzanakakis, Stem/Progenitor cell sources of insulin-producing cells for the treatment of diabetes. Tissue engineering, 2007. 13(7): p. 1399-1412.
  7. Madani, S., et al., Safety and efficacy of hematopoietic and mesanchymal stem cell therapy for treatment of T1DM: a systematic review and meta-analysis protocol. Systematic reviews, 2018. 7(1): p. 23.
  8. El-Badawy, A. and N. El-Badri, Clinical efficacy of stem cell therapy for diabetes mellitus: a meta-analysis. PLoS One, 2016. 11(4): p. e0151938.
  9. ClinicalTrials.gov. Umbilical Mesenchymal Stem Cells and Mononuclear Cells Infusion in Type 1 Diabetes Mellitus. [Date Accessed: 5/2018]; Available from: https://clinicaltrials.gov/ct2/show/NCT01374854.
  10. ClinicalTrials.gov. Use of Stem Cells in Diabetes Mellitus Type 1. [Date Accessed: 5/2018]; Available from: https://clinicaltrials.gov/ct2/show/NCT02940418.
  11. ClinicalTrials.gov. Stem Cell Mobilization (Plerixafor) and Immunologic Reset in Type 1 Diabetes (T1DM). [Date Accessed: 5/2018]; Available from: https://clinicaltrials.gov/ct2/show/NCT03182426.
  12. ClinicalTrials.gov. Mesenchymal Stem Cells to Intervene in the Development of Type 1 Diabetes: a Blinded Randomized Study. [Date Accessed: 5/2018]; Available from: https://clinicaltrials.gov/ct2/show/NCT02057211?term=stem+cells&cond=Type+1+Diabetes&rank=7.