The headlines proclaim “stem Cell success in Type I Diabetes.”
The headlines are misleading in several ways.

A better headline is in USAToday: “Stem cells “reset” to fight diabetes“, which is more correct but still unclear and misleading.
The disease being discussed is Type I Diabetes, that usually strikes young people. This is not the Type II diabetes that fat people and older people get, where you stil have insulin produced but not enough insulin. This is the one where you don’t have any insulin at all, and without shots will die within a week.

It is believed that Type I diabetes is an “autoimmune” disease. After a viral infection, for some reason the antibodies against the virus instead attack the Beta cells of the Pancreas, the cells that produce insulin.

So you see a child after a virus, and he’s sick and then starts feeling lousy. It’s not common, and easy to miss until the child ends up in the Emergency room dehydrated or in a coma.

But then, sometimes there is a “honeymoon” period when the Diabetes goes away, before it returns. It is thought that the virus hits the beta cells and destroys them, but then the beta cells regenerate or recover for awhile, until finally destroyed by the immune reaction.

That is why doctors are experimenting to see if treating newly diagnosed cases with Prednisone or other medicines that lower the immune response.

I have taken Prednisone at since October 2007 after an acute episode. In the years before, I had it again and again, and thus it had this time not much effect. Hardly any side effects like weight gain, fatigue, itching of the eyes, etc.

In this “stem cell study”, what was done was a variation on bone marrow transplant, where instead of using bone marrow, they used stem cells from the patient’s bone marrow to regenerate the immune system. So what they did was destroy the older cells that had been producing antibody that destroyed the Beta cells that produced insulin. To do this, they essentially destroyed the entire bone marrow.

But then they did a bone marrow transplant–using immature cells from the person’s own bone marrow. These immature cells would transform themselves into all the usual cells, but with the advantage that they were starting over in making an immune response, so they don’t produce antibodies to destroy the beta cells.

I think of this as gardening: You have bad plants full of rust or aphids (cells producing antibodies against the body), so you burn off the field and replace it with new seeds. (replacing the mature marrow with baby cells, i.e. stem cells).
Similar studies have been done using donor bone marrow, but using a donor increases the chance of rejection. This uses one’s own cells, and essentially “regrows” the marrow with immature cells that aren’t “primed” to make the bad antibody.
The procedure is exciting, since it could be used in other diseases where the body’s immune system destroys good tissue, such as Lupus or Multiple Sclerosis.

The bad news is that if you don’t have beta cells still alive, the treatment won’t work.

And that comes to the final confusion: The stem cells were adult stem cells, which are plentiful in the bone marrow. But with all the bills trying to reverse federal funding for Embryonic stem cell research, many people are not aware that adult stem cells are not only easier to obtain and a better genetic match, but have resulted in many types of treatment.

Which is why the LATimes, who backed spending millions to fund embryonic research, reminds readers that even though this used adult stem cells, we still need embryonic stem cells to make beta cells to transplant…

Well, maybe. Or maybe not. THIS ARTICLE discusses the theoretical pros and cons of adult vs embryonic stem cells for Diabetes. Both can produce beta cells, but the research is still preliminary, and years until treatment is started.

Embryonic stem cells potentially can become anything, but have the problem of overgrowing, not as good a genetic match, so people would have to stay on drugs to keep their immune system from rejecting the new cells. They are also hard to obtain, and very expensive. (few “left over” embryos are rarely donated by parents, who tend to view such embryos as potential life, and most embryos sitting around in freezers are “old” since newer fertility methods don’t “waste” as many embryos. That’s why most experiments are done with eggs and sperm donated from college students who are paid to take medicine to stimulate egg production).
Adult stem cells don’t overgrow, and scientists have already produced beta cells from bone marrow and liver. And you don’t have the problem of genetically different cells.
But unless you get rid of the destructive antibody that caused type I diabetes, mere transplants of insulin producing beta won’t help in type I Diabetes. You will need transplants plus anti immune drugs, or tranplants plus this bone marrow replacement with stem cells.

On the other hand, Type I Diabetes is so bad, it’s worth the effort.

We report, you decide.


Nancy Reyes is a retired physician living in the rural Philippines. Her webpage is Finest Kind CLinic and Fishmarket, and she writes medical essays on HeyDoc Xanga Blog

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