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The New Hope
Man, there’s been an amazing amount of buzz and excitement over new stem cell research out of Brazil that may “rein in Type 1 diabetes.” By injecting 15 patients with their own stem cells, researchers were able to get these people off insulin entirely without any major negative side effects — so far.
Luminaries are quoted as saying that this exciting new treatment “is a big deal,” but the follow-up
section in the LA Times notes: “Long-term effects of treatment unknown.”
The deal is this:
Using an approach mirroring bone marrow transplants used to treat patients with certain cancers and blood diseases, researchers in Brazil treated 15 patients newly diagnosed with Type 1 diabetes — “before their immune systems had the chance to eradicate all of their insulin-producing cells. The researchers hoped to preserve enough beta cells to make insulin injections unnecessary.”
Bone marrow contains hematopoietic stem cells, which are able to build all of the elements of the immune system. The idea was to “wipe out the faulty immune system and replace it with a new one that functions properly.”
Young patients, ages 14 to 31, “were treated with drugs and hormones that prompted the body to produce hematopoietic stem cells and send them from the bone marrow into the bloodstream, from which a machine then extracted them. About two weeks later, the patients checked into the hospital and received chemotherapy and other drugs to kill off their immune systems over a period of five days.”
“After a day of rest, they were infused with their own hematopoietic stem cells, which took about eight to 12 days to establish new immune systems. While the patients were without functioning immune systems, they were given antibiotics to protect them from possible infections.”
So far, side effects included only nausea, vomiting and hair loss. Yuck! But since these Type 1 patients were able to forgo insulin for months or even years, researchers are pretty sure they’re onto something here!
“It’s too early to call it a cure,” they say. It’s “highly experimental and potentially dangerous” (putting patients at risk for life-threatening infection, as the immune system is tampered with).
But “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.”
OMG. Hoping beyond hope? Watch the MSNBC video here.
Explore posts in the same categories: D-News Examined
Lose my hair for no more insulin? You betcha.
Posted by: Emily | April 12th, 2007 at 6:26 amA simply amazing story…
Diabetes cure? New hope or falsehope?
New research out of Brazil has indicated that it might be possible to cure diabetes. In a experiement that involved 15 people under the age of 30 the research were able to use stem cells harvested from the bone marrow to create a treatment that was i…
Posted by: "honey sweet" | April 12th, 2007 at 6:52 amDiabetes cure? New hope or falsehope?
New research out of Brazil has indicated that it might be possible to cure diabetes. In a experiement that involved 15 people under the age of 30 the research were able to use stem cells harvested from the bone marrow to create a treatment that was i…
Posted by: "honey sweet" | April 12th, 2007 at 6:52 amDiabetes cure? New hope or falsehope?
New research out of Brazil has indicated that it might be possible to cure diabetes. In a experiement that involved 15 people under the age of 30 the research were able to use stem cells harvested from the bone marrow to create a treatment that was i…
Posted by: "honey sweet" | April 12th, 2007 at 6:52 amSounds interesting and I hope they can learn something from the study. I read in one report that the nausea & hair loss were caused by the chemotherapy (similar to cancer chemo) that was done as part of the procedures. So far, this approach would help those who are newly diagnosed only… Another scientist suggested that a similar study would probably not be approved in the U.S. because of its highly risky procedures. But it is definitely interesting, since it was so successful for some of the participants.
Posted by: Anne | April 12th, 2007 at 9:46 amI have a newly diagnosed peanut. Would I have her endure life-threatening chemotherapy to wipe out her immune system to cure diabetes? No way. I guess I’m just not excited about this.
Posted by: Sarah | April 12th, 2007 at 10:03 amI think that they will find as they do further research that you don’t have to be newly diagnosed for it to work. There are several studies that show that beta cells regenerate themselves.
I think this is a huge step toward finding the cure.
Posted by: Penny | April 12th, 2007 at 10:43 amMy perspective on this is as follows. First, we shouldn’t get too excited about a trial that included just 15 people. However, it does sound promising for newly-diagnosed patients. I have read comments about immunosuppression, and Ryan Brunner said it best when he likened it to the “shoot anything that moves” mentality, figuring that, sure, you may kill a bunch of innocents, but, by golly, you got the fugitive in the process. But we should note that the treatment with immunosuppression was for a limited duration, unlike trying to live with insulin replacement therapy for life.
I would add that after more than 80 years on the market, insulin is the #1 medicine for “advese effects” resulting in hospitalization according to the Journal of the American Medical Association — responsible for some 58,000 hospitalizations every year, largely due to hypoglycemia (most type 1 patients suffer from a compromised counterregulatory system as well — generally not the case with type 2, but worth noting). Also, we now know that c-peptide, amylin and a host of other missing elements in patients with type 1 play a critical role in healthy metabolism, and without these things, the notion of “control” is akin to starting a fire with a few sticks. Perhaps it be done — much like starting a fire with sticks … if the sticks are dry enough, but its not quick, efficient or 100% guaranteed.
By comparison, this treatment was a relatively short period enduring chemotherapy, but then it was over and the need for insulin was also eliminated.
We should be cynical — it was a small study and the treatment failed in the first patient. The study authors suspect it was probably because their beta cell count was too low when they started the treatment. If true, that would render long-standing type 1 patients incurable with this method. But it does confirm that curing this type 1 diabetes is all about the immune system, while the focus of medical treatment has remained fixated on ameliorating the symptoms of the disease with glycemic control. I would be willing to consider a short duration of chemo if it meant I’d then have the exquisite control that only fully-functional beta cells can supply, but its very early and more work remains at this point!
Posted by: Scott | April 12th, 2007 at 10:48 amMy perspective on this is as follows. First, we shouldn’t get too excited about a trial that included just 15 people. However, it does sound promising for newly-diagnosed patients. I have read comments about immunosuppression, and Ryan Brunner said it best when he likened it to the “shoot anything that moves” mentality, figuring that, sure, you may kill a bunch of innocents, but, by golly, you got the fugitive in the process. But we should note that the treatment with immunosuppression was for a limited duration, unlike trying to live with insulin replacement therapy for life.
I would add that after more than 80 years on the market, insulin is the #1 medicine for “advese effects” resulting in hospitalization according to the Journal of the American Medical Association — responsible for some 58,000 hospitalizations every year, largely due to hypoglycemia (most type 1 patients suffer from a compromised counterregulatory system as well — generally not the case with type 2, but worth noting). Also, we now know that c-peptide, amylin and a host of other missing elements in patients with type 1 play a critical role in healthy metabolism, and without these things, the notion of “control” is akin to starting a fire with a few sticks. Perhaps it be done — much like starting a fire with sticks … if the sticks are dry enough, but its not quick, efficient or 100% guaranteed.
By comparison, this treatment was a relatively short period enduring chemotherapy, but then it was over and the need for insulin was also eliminated.
We should be cynical — it was a small study and the treatment failed in the first patient. The study authors suspect it was probably because their beta cell count was too low when they started the treatment. If true, that would render long-standing type 1 patients incurable with this method. But it does confirm that curing this type 1 diabetes is all about the immune system, while the focus of medical treatment has remained fixated on ameliorating the symptoms of the disease with glycemic control. I would be willing to consider a short duration of chemo if it meant I’d then have the exquisite control that only fully-functional beta cells can supply, but its very early and more work remains at this point!
Posted by: Scott | April 12th, 2007 at 10:49 amJust to note the first time insulin was tried it failed too. From what I read the first person in Brazil was given steroids which were then omitted. Whether the study was limited or not, with or without controls, honeymoon or not – this is the first time type 1 diabetes was reversed without a transplant of islet cells or a pancreas for any considerable length of time. In spite of the dangers there is a lot to be learned here and the methods refined and enhanced. Stay tuned
Posted by: Titos | April 12th, 2007 at 3:12 pmI really don’t see this study as promising as many are making it out to be. First of all, my understanding is it took place 3 years ago and only ONE of the 15 are still insulin free. The other 14 fell back onto insulin.
This process is no different than the current treatment going on with the Chicago Trials and other places throughout the country where they inject other people’s islet cells into you. The only difference here is they have eliminated the need for dangerous immunosuppresant drugs. However, they have now added more dangerous chemo drugs.
The idea of using chemo to treat anything should be looked against unless it is a life or death situation. Chemo has a 1-2% failure rate. That rate is ALOT higher than the rate of diabetes. And the last few months before dieing of chemo are worse than the few years of dieing from diabetes. Not to mention all of the other factors from chemo.
Granted, they don’t mention how strong the chemo is, but many times the person is banned from outside contact. They can’t go to the mall, go shopping, etc. Heck, I think they are even heavily limited in the foods they can eat due to contacting an illness.
While I think the idea of removing one’s on islets and freezing them is good. I still think we have a ways to go and this treatment doesn’t show anything new that we haven’t done besides add a very dangerous method such as chemo to the mix, which obviously doesn’t work anyways.
Posted by: Kevin D | April 13th, 2007 at 9:07 amI think the main issue with this is that the genetics for Type 1 and the trigger(s) are still present in the environment. Rebooting the immune system is step # 1. Step #2 is blocking exposure to the trigger(s) of Type 1 again, to prevent a relapse.
If you believe that a “leaky gut” is the point of entry for the trigger(s), then closing that leaky gut may potentially stop exposure to the trigger again. Thus, actively preventing Type 1 diabetes from re-occurring.
I think this research is not there YET, but its success in humans speaks for itself. It just needs to be fine-tuned and perfected. Perhaps at some point, they will be able to just reprogram the rouge T-cells that cause Type 1. Then they will be able to stop exposure to the trigger for Type 1, then they can add regenerative drugs/stem cells/transplants to help those who already have long-standing Type 1.
It’s too early to say yay or nay, but I’m leaning towards yay big time.
P.S. This is only my opinion. I am Science student and not a PhD.
Posted by: Sarah | April 13th, 2007 at 1:52 pmFrom what I read they are all off insulin. The longest for 35 months and counting. The others for less since they started later
Posted by: Titos | April 13th, 2007 at 2:17 pmTitos…it’s hard to say which is true. If you read the UK papers they say only 1 is still off insulin. If you read the American papers, they say the total opposite and that only 1 is back on insulin. Therefore I don’t know what to trust, but I know US media can blow anything out of proportion and make it incorrect therefore I believe the UK ones more, lol.
Posted by: Kevin D | April 14th, 2007 at 4:07 am