January - 12 - 2010
A study headed by researchers at the University of Florida have shown that autologous transfusion of umbilical cord blood is a safe and feasible treatment option in children with type 1 diabetes, although its efficacy is yet to be proven. Umbilical cord blood contains immature regulatory T-cells (Tregs), which may induce autoimmune tolerance and limit T-cell-mediated destruction of pancreatic beta cells. The study included 15 children (median age 5.23 years) with type 1 diabetes who received a single intravenous infusion of autologous cells and completed a 1-year follow-up. After this period, none of the participants experienced infusion-related or other type of adverse events. However, mean peak C-peptide levels decreased from 0.93 (IQR 0.7-2.03) ng/ml at baseline to 0.50 (0.26-1.30) ng/ml (P = 0.002) at 1 year postinfusion, indicating that treatment could not slow the decline of endogenous insulin secretion. At follow-up, median glycosylated hemoglobin was 7.0% (6.5-7.7) with no difference from baseline levels and median insulin requirements increased from 0.42 (0.21-0.55) to 0.67 (0.55-0.77) units/kg/day (P = 0.009). Changes in serum and peripheral blood immune markers such as autoantibody titers, Treg percentages, CD4-to-CD8 ratio, CD45RA and CD45RO levels, were not detected after 1 year of infusion (Haller, M.J. et al. Diabetes Care 2009, 32(11): 2041).