7) Co-infusion of autologous ISC with HSC represents a viable novel therapeutic option for IDDM. |
PMID:24317657 DOI:10.1007/s10238-013-0266-1 |
2015 Clinical and experimental medicine |
* Novel therapy for insulin-dependent diabetes mellitus: infusion of in vitro-generated insulin-secreting cells. |
- Insulin-dependent diabetes mellitus (IDDM) is a metabolic disease usually resulting from autoimmune-mediated β-cell destruction requiring lifetime exogenous insulin replacement. Mesenchymal stem cells (MSC) hold promising therapy. We present our experience of treating IDDM with co-infusion of in vitro autologous adipose tissue-derived MSC-differentiated insulin-secreting cells (ISC) with hematopoietic stem cells (HSC). This was an Institutional Review Board approved prospective non-randomized open-labeled clinical trial after informed consent from ten patients. ISC were differentiated from autologous adipose tissue-derived MSC and were infused with bone marrow-derived HSC in portal, thymic circulation by mini-laparotomy and in subcutaneous circulation. Patients were monitored for blood sugar levels, serum C-peptide levels, glycosylated hemoglobin (Hb1Ac) and glutamic acid decarboxylase (GAD) antibodies. Insulin administration was made on sliding scale with an objective of maintaining FBS < 150 mg/dL and PPBS around 200 mg/dL. Mean 3.34 mL cell inoculums with 5.25 × 10(4) cells/μL were infused. No untoward effects were observed. Over a mean follow-up of 31.71 months, mean serum C-peptide of 0.22 ng/mL before infusion had sustained rise of 0.92 ng/mL with decreased exogenous insulin requirement from 63.9 international units (IU)/day to 38.6 IU/day. Improvement in mean Hb1Ac was observed from 10.99 to 6.72%. Mean GAD antibodies were positive in all patients with mean of 331.10 IU/mL, which decreased to mean of 123 IU/mL. Co-infusion of autologous ISC with HSC represents a viable novel therapeutic option for IDDM. |
(1)22 therapeutic | (17)3 mutation | (33)2 approaches | (49)2 information |
(2)11 and | (18)3 paradigm | (34)2 autosomal | (50)2 inhibitors |
(3)8 mechanism | (19)3 role | (35)2 candidate | (51)2 learning |
(4)8 method | (20)3 strain | (36)2 cardiac | (52)2 modulators |
(5)7 approach | (21)3 target | (37)2 clinical | (53)2 object |
(6)7 mutations | (22)3 targeted | (38)2 compounds | (54)2 oral |
(7)6 therapies | (23)3 targets | (39)2 data | (55)2 polymer |
(8)5 technique | (24)3 treatment | (40)2 described | (56)2 potent |
(9)4 strategies | (25)3 type | (41)2 dual | (57)2 prognostic |
(10)4 strategy | (26)3 words | (42)2 electroporation | (58)2 putative |
(11)4 surgical | (27)2 *null* | (43)2 finding | (59)2 recombinants |
(12)3 antibacterial | (28)2 anti-tumor | (44)2 findings | (60)2 results |
(13)3 drug | (29)2 antibiotic | (45)2 form | (61)2 therapeutical |
(14)3 homozygous | (30)2 anticancer | (46)2 genetic | (62)2 titanium |
(15)3 insights | (31)2 application | (47)2 imaging | (63)2 treatments |
(16)3 mechanisms | (32)2 applications | (48)2 in |
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