Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus

Background Autologous peripheral stem cell transplantation was first reported in 2007 to treat type 1 diabetes mellitus (DM) and achieved encouraging effect, but whether similar outcome can be achieved in type 2 DM is not well demonstrated. The objective of this study was to determine the effect of...

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Veröffentlicht in:Chinese medical journal 2011-11, Vol.124 (22), p.3622-3628
Hauptverfasser: Wang, Li, Zhao, Shi, Mao, Hong, Zhou, Ling, Wang, Zhong-Jing, Wang, Hong-Xiang
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container_end_page 3628
container_issue 22
container_start_page 3622
container_title Chinese medical journal
container_volume 124
creator Wang, Li
Zhao, Shi
Mao, Hong
Zhou, Ling
Wang, Zhong-Jing
Wang, Hong-Xiang
description Background Autologous peripheral stem cell transplantation was first reported in 2007 to treat type 1 diabetes mellitus (DM) and achieved encouraging effect, but whether similar outcome can be achieved in type 2 DM is not well demonstrated. The objective of this study was to determine the effect of combination of autologous bone marrow stem cell transplantation (BMT) and hyperbaric oxygen treatment on type 2 DM. Methods The study involved 31 patients with type 2 DM (aged 33 to 62 years) from January 2009 to January 2011 in the Central Hospital of Wuhan, China. Clinical variables (body mass index, duration of DM, insulin requirement, oral hypoglycemic drugs, time free from insulin, time free from oral drugs) and laboratory variables (hemoglobin Alc (HbAlc)) mononuclear cells infused, and C-peptide in four time points) were assessed. Purified bone marrow stem cells were infused into major pancreatic arteries. Follow-up was performed at the 30, 90, 180, 360, 540 and 720 days (mean 321 days) after BMT. Results Mean HbAlc values showed a significant reduction during follow-up in all patients after BMT. It decreased by more than 1.5% (from 8.7% to 7.1%) as quickly as at 30 days after BMT. Afterwards mean HbAlc fluctuated between plus or minus 0.5% until 24 months rather than declined continuously. At 90 days after the combined therapy C-peptide increased significahtly compared with baseline (P 〈0.0001). But in other time points C-peptide was similar with baseline data (P〉0.3). All patients had insulin and/or oral hypoglycemic drugs reduced to different levels. The dose of insulin of 7 patients (7/26, 27%) reduced for a period of time after BMT. Conclusions Combined therapy of intrapancreatic BMT and hyperbaric oxygen treatment can improve glucose control and reduce the dose of insulin and/or oral hypoglycemic drugs in type 2 DM patients, but it only improve pancreatic 13-cell function transiently. Further randomized controlled clinical trials involved more patients will be required to confirm these findings and the mechanism needs to be illustrated deeply.
doi_str_mv 10.3760/cma.j.issn.0366-6999.2011.22.005
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The objective of this study was to determine the effect of combination of autologous bone marrow stem cell transplantation (BMT) and hyperbaric oxygen treatment on type 2 DM. Methods The study involved 31 patients with type 2 DM (aged 33 to 62 years) from January 2009 to January 2011 in the Central Hospital of Wuhan, China. Clinical variables (body mass index, duration of DM, insulin requirement, oral hypoglycemic drugs, time free from insulin, time free from oral drugs) and laboratory variables (hemoglobin Alc (HbAlc)) mononuclear cells infused, and C-peptide in four time points) were assessed. Purified bone marrow stem cells were infused into major pancreatic arteries. Follow-up was performed at the 30, 90, 180, 360, 540 and 720 days (mean 321 days) after BMT. Results Mean HbAlc values showed a significant reduction during follow-up in all patients after BMT. It decreased by more than 1.5% (from 8.7% to 7.1%) as quickly as at 30 days after BMT. Afterwards mean HbAlc fluctuated between plus or minus 0.5% until 24 months rather than declined continuously. At 90 days after the combined therapy C-peptide increased significahtly compared with baseline (P 〈0.0001). But in other time points C-peptide was similar with baseline data (P〉0.3). All patients had insulin and/or oral hypoglycemic drugs reduced to different levels. The dose of insulin of 7 patients (7/26, 27%) reduced for a period of time after BMT. Conclusions Combined therapy of intrapancreatic BMT and hyperbaric oxygen treatment can improve glucose control and reduce the dose of insulin and/or oral hypoglycemic drugs in type 2 DM patients, but it only improve pancreatic 13-cell function transiently. Further randomized controlled clinical trials involved more patients will be required to confirm these findings and the mechanism needs to be illustrated deeply.</description><identifier>ISSN: 0366-6999</identifier><identifier>EISSN: 2542-5641</identifier><identifier>DOI: 10.3760/cma.j.issn.0366-6999.2011.22.005</identifier><identifier>PMID: 22340214</identifier><language>eng</language><publisher>China: Department of Endocrinology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology,Wuhan, Hubei 430014, China</publisher><subject>2型糖尿病 ; Adult ; Bone Marrow Cells - cytology ; Diabetes Mellitus, Type 2 - metabolism ; Diabetes Mellitus, Type 2 - therapy ; Female ; Glycated Hemoglobin A - metabolism ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stem Cell Transplantation - methods ; 基线数据 ; 干细胞移植 ; 移植治疗 ; 糖化血红蛋白 ; 自体 ; 骨髓干细胞 ; 高压氧治疗</subject><ispartof>Chinese medical journal, 2011-11, Vol.124 (22), p.3622-3628</ispartof><rights>Copyright © Wanfang Data Co. Ltd. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c330t-44474f97da7e416f5fbefd93a5a5da8393f4eea27a94dbcadef96246b2bae6b43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/85656X/85656X.jpg</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22340214$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Li</creatorcontrib><creatorcontrib>Zhao, Shi</creatorcontrib><creatorcontrib>Mao, Hong</creatorcontrib><creatorcontrib>Zhou, Ling</creatorcontrib><creatorcontrib>Wang, Zhong-Jing</creatorcontrib><creatorcontrib>Wang, Hong-Xiang</creatorcontrib><title>Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus</title><title>Chinese medical journal</title><addtitle>Chinese Medical Journal</addtitle><description>Background Autologous peripheral stem cell transplantation was first reported in 2007 to treat type 1 diabetes mellitus (DM) and achieved encouraging effect, but whether similar outcome can be achieved in type 2 DM is not well demonstrated. The objective of this study was to determine the effect of combination of autologous bone marrow stem cell transplantation (BMT) and hyperbaric oxygen treatment on type 2 DM. Methods The study involved 31 patients with type 2 DM (aged 33 to 62 years) from January 2009 to January 2011 in the Central Hospital of Wuhan, China. Clinical variables (body mass index, duration of DM, insulin requirement, oral hypoglycemic drugs, time free from insulin, time free from oral drugs) and laboratory variables (hemoglobin Alc (HbAlc)) mononuclear cells infused, and C-peptide in four time points) were assessed. Purified bone marrow stem cells were infused into major pancreatic arteries. Follow-up was performed at the 30, 90, 180, 360, 540 and 720 days (mean 321 days) after BMT. Results Mean HbAlc values showed a significant reduction during follow-up in all patients after BMT. It decreased by more than 1.5% (from 8.7% to 7.1%) as quickly as at 30 days after BMT. Afterwards mean HbAlc fluctuated between plus or minus 0.5% until 24 months rather than declined continuously. At 90 days after the combined therapy C-peptide increased significahtly compared with baseline (P 〈0.0001). But in other time points C-peptide was similar with baseline data (P〉0.3). All patients had insulin and/or oral hypoglycemic drugs reduced to different levels. The dose of insulin of 7 patients (7/26, 27%) reduced for a period of time after BMT. Conclusions Combined therapy of intrapancreatic BMT and hyperbaric oxygen treatment can improve glucose control and reduce the dose of insulin and/or oral hypoglycemic drugs in type 2 DM patients, but it only improve pancreatic 13-cell function transiently. Further randomized controlled clinical trials involved more patients will be required to confirm these findings and the mechanism needs to be illustrated deeply.</description><subject>2型糖尿病</subject><subject>Adult</subject><subject>Bone Marrow Cells - cytology</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Female</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Stem Cell Transplantation - methods</subject><subject>基线数据</subject><subject>干细胞移植</subject><subject>移植治疗</subject><subject>糖化血红蛋白</subject><subject>自体</subject><subject>骨髓干细胞</subject><subject>高压氧治疗</subject><issn>0366-6999</issn><issn>2542-5641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1P3DAQhq0KVLbQv1CZC_SS1Bl_BB8RgrYSUi_0SjRJxrtZJfYSO0Lw6_FqgdNIo-edV_Mw9rMSpayN-NVNWG7LIUZfCmlMYay1JYiqKgFKIfQXtgKtoNBGVUds9cmcsG8xboUArWvzlZ0ASCWgUiv2eL2kMIZ1WCJvgyc-4TyHZx4TTbyjceRpRh93I_qEaQieuzDztKG8J0wT-cSD4-llRxx4P2BLiSKfcnJISzxjxw7HSN_f5yn7f3f7cPOnuP_3--_N9X3RSSlSoZSqlbN1jzWpyjjtWnK9lahR93glrXSKCKFGq_q2w56cNaBMCy2SaZU8ZReHu8_oHfp1sw3L7HNj87rppu1eEUAWlMHLA7ibw9NCMTXTEPd_oqfsoLEAWpgK9uSPd3JpJ-qb3TxkNy_Nh7sMnB-AbhP8-mnIrR-Myn21VFfyDRyzgjI</recordid><startdate>20111120</startdate><enddate>20111120</enddate><creator>Wang, Li</creator><creator>Zhao, Shi</creator><creator>Mao, Hong</creator><creator>Zhou, Ling</creator><creator>Wang, Zhong-Jing</creator><creator>Wang, Hong-Xiang</creator><general>Department of Endocrinology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology,Wuhan, Hubei 430014, China</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>W91</scope><scope>~WA</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>20111120</creationdate><title>Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus</title><author>Wang, Li ; Zhao, Shi ; Mao, Hong ; Zhou, Ling ; Wang, Zhong-Jing ; Wang, Hong-Xiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c330t-44474f97da7e416f5fbefd93a5a5da8393f4eea27a94dbcadef96246b2bae6b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>2型糖尿病</topic><topic>Adult</topic><topic>Bone Marrow Cells - cytology</topic><topic>Diabetes Mellitus, Type 2 - metabolism</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Female</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Stem Cell Transplantation - methods</topic><topic>基线数据</topic><topic>干细胞移植</topic><topic>移植治疗</topic><topic>糖化血红蛋白</topic><topic>自体</topic><topic>骨髓干细胞</topic><topic>高压氧治疗</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Li</creatorcontrib><creatorcontrib>Zhao, Shi</creatorcontrib><creatorcontrib>Mao, Hong</creatorcontrib><creatorcontrib>Zhou, Ling</creatorcontrib><creatorcontrib>Wang, Zhong-Jing</creatorcontrib><creatorcontrib>Wang, Hong-Xiang</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库-医药卫生</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Wanfang Data Journals - Hong Kong</collection><collection>WANFANG Data Centre</collection><collection>Wanfang Data Journals</collection><collection>万方数据期刊 - 香港版</collection><collection>China Online Journals (COJ)</collection><collection>China Online Journals (COJ)</collection><jtitle>Chinese medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Li</au><au>Zhao, Shi</au><au>Mao, Hong</au><au>Zhou, Ling</au><au>Wang, Zhong-Jing</au><au>Wang, Hong-Xiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus</atitle><jtitle>Chinese medical journal</jtitle><addtitle>Chinese Medical Journal</addtitle><date>2011-11-20</date><risdate>2011</risdate><volume>124</volume><issue>22</issue><spage>3622</spage><epage>3628</epage><pages>3622-3628</pages><issn>0366-6999</issn><eissn>2542-5641</eissn><abstract>Background Autologous peripheral stem cell transplantation was first reported in 2007 to treat type 1 diabetes mellitus (DM) and achieved encouraging effect, but whether similar outcome can be achieved in type 2 DM is not well demonstrated. The objective of this study was to determine the effect of combination of autologous bone marrow stem cell transplantation (BMT) and hyperbaric oxygen treatment on type 2 DM. Methods The study involved 31 patients with type 2 DM (aged 33 to 62 years) from January 2009 to January 2011 in the Central Hospital of Wuhan, China. Clinical variables (body mass index, duration of DM, insulin requirement, oral hypoglycemic drugs, time free from insulin, time free from oral drugs) and laboratory variables (hemoglobin Alc (HbAlc)) mononuclear cells infused, and C-peptide in four time points) were assessed. Purified bone marrow stem cells were infused into major pancreatic arteries. Follow-up was performed at the 30, 90, 180, 360, 540 and 720 days (mean 321 days) after BMT. Results Mean HbAlc values showed a significant reduction during follow-up in all patients after BMT. It decreased by more than 1.5% (from 8.7% to 7.1%) as quickly as at 30 days after BMT. Afterwards mean HbAlc fluctuated between plus or minus 0.5% until 24 months rather than declined continuously. At 90 days after the combined therapy C-peptide increased significahtly compared with baseline (P 〈0.0001). But in other time points C-peptide was similar with baseline data (P〉0.3). All patients had insulin and/or oral hypoglycemic drugs reduced to different levels. The dose of insulin of 7 patients (7/26, 27%) reduced for a period of time after BMT. Conclusions Combined therapy of intrapancreatic BMT and hyperbaric oxygen treatment can improve glucose control and reduce the dose of insulin and/or oral hypoglycemic drugs in type 2 DM patients, but it only improve pancreatic 13-cell function transiently. Further randomized controlled clinical trials involved more patients will be required to confirm these findings and the mechanism needs to be illustrated deeply.</abstract><cop>China</cop><pub>Department of Endocrinology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology,Wuhan, Hubei 430014, China</pub><pmid>22340214</pmid><doi>10.3760/cma.j.issn.0366-6999.2011.22.005</doi><tpages>7</tpages></addata></record>
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subjects 2型糖尿病
Adult
Bone Marrow Cells - cytology
Diabetes Mellitus, Type 2 - metabolism
Diabetes Mellitus, Type 2 - therapy
Female
Glycated Hemoglobin A - metabolism
Humans
Male
Middle Aged
Prospective Studies
Stem Cell Transplantation - methods
基线数据
干细胞移植
移植治疗
糖化血红蛋白
自体
骨髓干细胞
高压氧治疗
title Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus
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