Insulin-secreting adipose derived mesenchymal stem cells with bone marrow derived hematopoietic stem cells from autologous and allogenic sources for type-1 diabetes mellitus

Abstract

Back ground: Stem cell therapy (SCT) is now the up-coming therapeutic modality for treatrment of type-1 diabetes mellitus (T1DM). Material and Methods: Our study was prospective open-labeled 2-armed trial, for 10-T1DM patients in each arm of allogenic and autologous adipose-derived insulin-secreting mesenchymal stem cells (IS-AD-MSC)+bone-marrow derived hematopoietic stem cells (BM-HSC) infusion. Group-1 received autologous SCT with 9-males, 1-female with mean age, 20.2-years, disease duration (DD) 8.1-years and group-2 received allogenic SCT with 6-males, 4-females with mean age, 19.7-years, and DD 7.9-years. Glycosylated hemoglobin (HbA1c) was 10.99%; Serum(S.) C-peptide, 0.22ng/ml and insulin requirement, 63.9IU/day in group-1 and HbA1c was 11.93%, S.C-peptide 0.028ng/ml and insulin requirement 57.55IU/day in group-2. SC were infused into portal+thymic circulation and subcutaneous tissue under non-myeloablative conditioning. Patients were monitored for blood-sugar, S.C-peptide, GAD antibodies and Hb1Ac at 3-monthly intervals. Results: Group-1 received mean SC 103.14ml with 2.65x102 ISC/µL, CD34+ 0.81% and CD45-/90+/73+, 81.55%. Group-2 received mean SC 95.33ml with 2.07x102 ISC/µL, CD34+ 0.32% and CD45-/90+/73+ 54.04%. No untoward effect was observed with sustained improvement in HbA1c and S.C-peptide in both groups with decrease in GAD-antibodies and reduction in mean insulin requirement. Conclusion: SCT is safe and viable treatment option for T1DM. Autologous IS-AD-MSC+BM-HSC co-infusion offers better long-term control of hyperglycemia as compared to allogenic SCT.