Intrapancreatic autologous stem cell therapy for type 1 Diabetes
Title: Intrapancreatic autologous stem cell therapy for type 1 Diabetes Introduction: Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, is a chronic autoimmune condition in which the pancreas makes little or no insulin leading to resultant hyperglycemia. The incidence of type 1 diabetes in India is 0.26/1000 children. The disease is treated by insulin injection and islet cell transplantation which are the FDA approved treatments at present. Since stem cells given intravenously achieve a low concentration in the pancreas, I developed a novel technique of implanting the stem cells directly into the pancreas through its arterial blood supply. Materials and methods: Last 5 years I treated 25 patients of Type 1 diabetes with autologous intrapancreatic stem cell therapy and in the same period, a group of 26 patients of Type 1 diabetes with conventional treatment of Insulin injections was put as a control group. Stem cells were harvested from patients own bone marrow separated by density gradient method and from Omental fat digested enzymatically by type 1 collagenase enzyme. An infusion of 20 mg/kg methylprednisolone in 100 ML normal saline given intravenously over 1 hour prior to the therapy. The total average numbers of cells harvested were 8.86 × 107. Results: The minimum follow up was 6 months and maximum of 5 years. In the therapy group, the average weight gain after one year of therapy, daily requirement of Insulin and its drop after therapy, drop in HbA1c levels, drop in fasting and post prandial blood sugar, rise of C peptide levels and drop in Anti-GAD antibody titer were measured and was found to be statistically highly significant. The same parameters were measured in control group and were not significant statistically. There were a few side effects noted after stem cell therapy such as mild skin rash, nausea, and pain in abdomen. Discussion: When stem cells are given intravenously, majority are engulfed by lungs and only a small fraction is delivered to the pancreas. When injected intapancreatically through its arterial blood supply, due to the larger size and irregular shape of stem cells, they are retained in tissue spaces and do not escape from venous side thus achieving far higher concentration in pancreas compared to intravenous route. Conclusions: Intrapancreatic Stem cell therapy for Type 1 diabetes is safe, affordable and effective. We need a greater number of cases and a longer follow up to make it even better. Keywords: Intrapancreatic Stem cell therapy for type 1 diabetes, Type 1 diabetes, Stem cell therapy, Stem cell therapy for type 1 diabetes, Reversal of autoimmunity in type 1 diabetes by stem cell therapy etc.
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