Combined Treatment of Intrapancreatic Autologous Bone Marrow Stem Cells and Hyperbaric Oxygen in Type 2 Diabetes Mellitus

Abstract

The objective of this study was to determine whether the combination therapy of intrapancreatic autologous stem cell infusion (ASC) and hyperbaric oxygen treatment (HBO) before and after ASC can improve islet function and metabolic control in patients with type 2 diabetes mellitus (T2DM). This prospective phase 1 study enrolled 25 patients with T2DM who received a combination therapy of intrapancreatic ASC and periinfusion HBO between March 2004 and October 2006 at Stem Cells Argentina Medical Center Buenos Aires, Argentina. Clinical variables (body mass index, oral hypoglycemic drugs, insulin requirement) and metabolic variables (fasting plasma glucose, C-peptide, HbA1c, and calculation of C-peptide/glucose ratio) were assessed over quartile periods starting at baseline and up to 1 year follow-up after intervention. Means were calculated in each quartile period and compared to baseline. Seventeen male and eight female patients were enrolled. Baseline variables expressed as means ± SEs were: age 55 ± 2.14 years, diabetes duration 13.2 ± 1.62 years, insulin dose 34.8 ± 2.96 U/day, and BMI 27.11 ± 0.51. All metabolic variables showed significant improvement when comparing baseline to 12 months follow-up, respectively: fasting glucose 205.6 ± 5.9 versus 105.2 ± 14.2 mg/dl, HbA1c 8.8 ± 0.2 versus 6.0 ± 0.4%, fasting C-peptide 1.5 ± 0.2 versus 3.3 ± 0.3 ng/ml, C-peptide/glucose ratio 0.7 ± 0.2 versus 3.5 ± 0.3, and insulin requirements 34.8 ± 2.9 versus 2.5 ± 6.7 U/day. BMI remained constant over the 1-year follow-up. Combined therapy of intrapancreatic ASC infusion and HBO can improve metabolic control and reduce insulin requirements in patients with T2DM. Further randomized controlled clinical trials will be required to confirm these findings.

Long term effects of the implantation of autologous bone marrow mononuclear cells for type 2 diabetes mellitus

“…Several studies of T1DM have also shown that autologous nonmyeloablative hematopoietic stem cell transplantation along with high-dose immunosuppression resulted in prolonged insulin independence in the majority of patients [18][19][20]. The final pathway of beta-cell injury in both type 1 and 2 diabetes is common, involving glucotoxicity, lipotoxicity, and cytotoxic cytokines [21], leading to similar damage to the local microenvironment in the pancreas in both types of diabetes. Previous reports indicated that multipotent stem cells could promote healing of type 2 diabetic ischemic limbs [22][23][24].…”

Bone Marrow-Derived Stem Cell Transplantation for the Treatment of Insulin-Dependent Diabetes

“…A recent prospective phase 1 study of 25 patients, evaluated the impact of autologous BMT on the metabolic control of subjects with T2D [59]. The mononuclear fraction of a buffy coat, obtained from BMSC (from iliac crest aspirates) and peripheral blood, was injected via selective cannulation of the dorsal pancreatic artery, under angiographic guidance.…”

Adipose stem cell-based regenerative medicine for reversal of diabetic hyperglycemia

“…However, only a few cases of stem cell-based research were performed recently [118][119][120][121][122] to develop a therapeutic option for type 2 diabetes, as type 1 diabetes has stood as the forefront. Deriving insulinsecreting β-cells from stem cells for treatment of type 1 diabetes seems relatively straightforward compared to developing an alternative treatment option for type 2 diabetes.…”