Tagged: Diabetes mellitus type 1

Banking on cord blood

Well, the internet knows I’m pregnant.

Maybe it’s my lazy way of shopping for maternity clothes.  Maybe it’s all those searches for silly pregnancy advice.  Whatever it is, the internet knows I’m pregnant and now pregnancy related ads follow me everywhere.

The latest – Umbilical Cord Blood Banking.

I didn’t even realize this was an industry!

With tags like “Could One Day Be a Lifeline of Hope for Your Child” and “Saving More Cells-Saving More Hope”,  how can one pregnant lady resist?

Yes, promising to save my unborn child from leukemia AND save me $300 if I sign up now is very enticing.  Apparently, there are 80+ diseases that I could rescue this baby from by simply bagging up the umbilical cord and paying a company to safeguard until later use. Still not convinced, until I saw a point about it being used as a cure for Type 1 Diabetes.  Really?  This disease has the best likelihood of actually affecting my family, I paused and thought about it – should I bank my cord blood?

Although perfect in nearly every way, my husband is defective (love you, honey).
If not for the wonders of modern medicine, nature would have killed him off around 14 years of age when Type 1 Diabetes caused him to become completely dependent on insulin injections.  Because this disease is genetic, there is a good chance our little bundle will be carrying this defect and either developing Type 1 Diabetes or passing it along.

A brief overview of the disease – Type 1 Diabetes occurs when certain cells in the immune system (white blood cells called T lymphocytes) decide to gang up on little groups of cells in the pancreas called islet β cells.  What triggers these T cells, normally defenders of the realm, to turn into maniacal bullies targeting their own kind is still a bit of a mystery  But what we do know is that these crazed T cells are very effective in their islet β cells annihilation.  Type 1 Diabetes is no longer fatal if treated but it is chronic – all patients have to pick up the slack for their islet cell lacking pancreases and provide their bodies with every drop of insulin their body will need to deal with sugar appropriately throughout the day, every day for the rest of their lives.

Where does umbilical cord blood come in?  Well, cord blood is rich with stem cells.  And stem cells, especially the unique ones found in cord blood, have yet to be programmed, they don’t have a strict plan for their cellular destiny.  This makes them naive enough to be tricked into becoming any number of cell types across the body – perhaps even…. insulin-producing cells!  So, could stem cell rich cord blood actually be the answer to treating this baby’s possible Type 1 Diabetes?  Could my husband be treated with this magic blood and be cured?

Back to reality – the problem with stem cell therapy for Type 1 Diabetes is that even if you get those islet cells regenerated, the T cell bullies are still hanging around, waiting to beat them down. How could stem cells from cord blood be any different?

This is where I found some really freaking cool science.

As pointed out in a paper in Autoimmunity Reviews by Zhao and Mazzone in 2010, there are three main things that cord blood stem cells will have to accomplish to cure a Type 1 diabetic: 1) bulk up the stock of insulin-producing cells, 2) protect any introduced/re-grown islet β cells and 3) get the patient’s T cells back in line so they won’t attack and destroy.  And this research team may have found a way to tackle all of these points using cord blood stem cells using a very unexpected approach.

Zhao’s team followed up this tease of a review with a study published in BMC Medicine in 2012.  Rather than trying to introduce or re-grow insulin-producing cells, the team used the cord blood stem cells to educate the bad T lymphocytes.

That’s right! The baby cells are basically sitting this old guys down and saying “Listen up, its time to shape up and stop bullying the islet cells!”

How?  Well, this is a bit more complicated that I can even fully wrap my head around, but the gist of it is this:  lymphocytes are isolated from the patient’s blood and cycled through a column of petri dishes that are coated with the cord blood stem cells.  These stem cells have an added bonus property of sticking really well to the petri dish such that the lymphocytes feeding through the petri dish stacks simply bounce along the top of the stem cells, which are attached tightly to the dish.  As they bounce along, the lymphocytes hang out in the presence of the stem cells long enough for the stem cells to bestow their baby wisdom upon them.  What is this baby wisdom you may ask?  A micro environment created by different secreted molecules and molecules on the surface of the stem cells that alters how the patient’s lymphocytes respond to immune challenge.  Let’s just call this the “happy place”.

Once the patient’s lymphocytes visit the “happy place”, they are returned into the patients blood stream.  These lymphocytes have been schooled, educated, seen the light and turned away from the dark side.

As tested on a small number of patients (12 receiving treatment, 3 placebo), either showing a degree of islet β cells activity (group A = 6 patients) or absolutely no activity (group B = 6 patients), this Stem Cell Educator therapy was able to return insulin regulation capabilities.  Group A patients, who went in with subpar insulin responses, regained normal levels of insulin activity within 4 weeks of treatment.  Group B patients, who went in with no insulin activity whatsoever, were already progressing to normal insulin activity within 12 weeks and nearly matching normal levels at the end of the study (40 weeks).

To reiterate:  Group B patients went into the clinic with no insulin activity suggesting they had absolutely not a single working insulin-secreting cell in their bodies.  After one treatment with the cord blood stem cells educating the patient’s lymphocytes, insulin activity was nearly regained.  This suggests that either even these patients have a population of islet β cells struggling to survive or have other unidentified insulin-producing cells waiting in the wings, but the crazy T lymphocytes are constantly playing whack-a-mole to keep the numbers down.  Educate the lymphocytes, let these cells bounce back, BAM, Type 1 Diabetes cured?  Maybe someday.

To get back to why this relates to me and my pregnancy – I have decided that I am going to try my damndest to donate my cord blood.  I am sure this is only one of many amazing scientific pursuits cord blood stem cells are currently being used for and it seems a shame to let those precious precious cells get incinerated in a sad medical waste facility.

I’m still weighing my options, but I did find a helpful list of cord blood banks (public and private).

Maybe those cells will go on to save someone’s life.
Maybe a researcher will use them to cure Type 1 Diabetes.

Maybe this is just my way of making this baby a little scientist in utero.
“What are you up to, baby?”
“You know, just culturing some miracle cells inside the womb”.