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题名:Novel therapy for insulin-dependent diabetes mellitus: infusion of in vitro-generated insulin-secreting cells.
作者:DAVE SD; VANIKAR AV; TRIVEDI HL; THAKKAR UG; GOPAL SC; CHANDRA T;
来源:Clin Exp Med. 2013 Dec 7. [ IF= 0.00 ] ]
URL :10.1007/s10238-013-0266-1
日期:20140102
摘要:Insulin-dependent diabetes mellitus (IDDM) is a metabolic disease usually
resulting from autoimmune-mediated beta-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 x 104
cells/muL 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.

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