Mesenchymal Stem Cells transplantation

Research on Stem Cells in Treatment of Diabetes

By Pablo de Moraes

Recent discoveries and studies are successful doing science world eyes return to Brazil. It is a team of scientists from the University of São Paulo, Ribeirão Preto, has achieved outstanding results in research with stem and due to the success were highlighted in major journals worldwide, including the Jama (Journal of the American Medical Association).

The news was presented recently during a talk at the State Institute of Diabetes and Endocrinology Luiz Capriglione (IEDE), In Rio de Janeiro, made by Eduardo Couri, A leader of the research.

Hematopoietic Stem

One of the protocols presented was the "Autologous Transplantation of Hematopoietic Stem Cells in Patients with Newly Diagnosed DM1. According to Dr. Eduardo Couri, is initially made a collection of stem cells Hematopoietic and then they are frozen. After two weeks, it is the severe immunosuppression in order to completely destroy immune "Defective" the person with diabetes.

"It's like a shutdown of the immune system with chemotherapy in a hospital environment, using drugs such as cyclophosphamide and antithymocyte globulin intravenous for five days," says the doctor.

According to him, then the immune system is "reconnected" with the use of hematopoietic stem cells from the patient. Occurs what we call 'reset immune', causing the immune system to stop attacking pancreatic beta-cells. Thus, the remaining beta cells, which have not been destroyed, tend to produce insulin properly again, "he said. "This is why we only work with people in the onset of diabetes, aged between 12 and 35 years, with less than six weeks of diagnosis," he adds.

The method showed excellent results: the 23 people who participated in the process, 20 stopped using insulin at some point, and 12 remained continuously free and 8 temporarily. "They are not cured, but controlled and free insulin. They have done a Alimentary Education and currently monitor the glucose and daily practice physical activities constantly, "says the doctor.

Mesenchymal Stem

The second protocol was presented which uses infusion of mesenchymal stem cells, taken from the bone marrow of a first-degree relative of the patient. According to Dr. Eduardo Couri, in animal studies, these cells showed the ability to block the phenomenon of autoimmunity and promote the regeneration of beta cells, reversing the Type 1 diabetes.

The treatment is as follows: the donor, which can only be a first-degree relative, receive general anesthesia for the collection of bone marrow cells. Then, the mesenchymal cells are proliferating in the laboratory. Subsequently, the patient receives consecutive intravenous infusions of these cells. According to Dr. Eduardo Couri, infusions are simple, not involving prolonged hospitalization. Once deployed, they migrate to the inflamed tissue (in case the pancreas) and settle there.

This procedure is being done only in people aged 12 to 35 yearsWith less than four weeks of diabetes. "In that first moment, we are working with newly diagnosed diabetes, but we will soon, depending on the results, carry it in people with long-term, which is the majority," said the doctor.

To date, three patients participated. Of these, one of them managed to be free of insulin, however, the diabetes is uncontrolled. "We are in the research phase of thinking more than acting, we must agree doses, assess risks, and then begin treatment for those with diabetes for longer," he says.

Pioneering

According to Dr. Eduardo Couri, other research has been conducted around the world, but the group of Ribeirão Preto is a pioneer, the greatest number of patients included and the greatest return. A major limitation, however, is the high cost of procedures, since the methods require the-art laboratories and personnel types within.

For the president of SBEM and director of IEDE, Dr. Ricardo Meirelles, the studies are extremely important to improve the lives of patients with diabetes. "In recent years we have had many advances in the treatment, but certainly the recovery of pancreatic cells, or at least preserve them, is the best way you can prevent diabetes continues to evolve and, therefore, appears to be one of the most promising treatment in time, "he said. "It's a matter of pride for Brazil," he adds.

Descoberta chave para reversão do Diabetes tipo 1

Descoberta Chave para reverter Diabetes Tipo 1

The Journal of Clinical Endocrinology and Metabolism. Fevereiro 2010

Os membros de uma equipe de pesquisa no centro, liderada por Jerry Nadler, MD, professor e chefe da cadeira da medicina interna e director do centro de pesquisas The Clinical Research Center of Eastern Virginia Medical School, estão estudando o papel da enzima 12-Lipoxigenase (12-LO) e sua relação no desenvolvimento do diabetes Tipo 1 . Eles esperam que o estudo e a segmentação desta enzima será a chave para a cura do DMT1.
A diabetes tipo 1 é uma condição crônica que se desenvolve quando o pâncreas pára de gerar insulina suficiente para manter os níveis normais de glicose (açúcar) no sangue. A insulina move o açúcar da da corrente sanguínea para as células do corpo, de modo este açúcar possa ser usado para gerar energia. Na diabetes tipo 1, os ataques ao sistema imunológico, detróem as células produtoras de insulina chamadas de células beta, células uqe são encontradas apenas no pâncreas. Quando as células beta morrem, o corpo não consegue produzir insulina suficiente para regular os níveis de glicose, e isto pode levar a graves complicações de saúde, até a morte, quando o tratamento com a correta reposição de insulina não é adequadamente realizado.
Atualmente é amplamente aceito que a inflamação desempenha um papel fundamental na destruição das células beta. Mas os fatores precisos ainda não são totalmente bem conhecidos. A base de proteína enzima encontrada em células beta, a 12-LO produz lipídios específicos que causam a inflamação e pode levar à morte das células beta, em modelos laboratoriais. Na verdade, os pesquisadores demonstraram que eliminar o gene que produz 12-LO, impede o desenvolvimento da diabetes tipo 1 em ratos.
Dr. Nadler, explica que o desafio tem sido a de validar a 12-LO e seus produtos lipídicos pró-inflamatórios como tendo um papel no diabetes humano. Ter acesso às células beta humanas é difícil, mas o The Clinical Research Center of Eastern Virginia Medical School (EVMS) está entre um número limitado de grupos de pesquisa que podem receber as ilhotas humanas - a região do pâncreas, que contém células beta - de pessoas que doaram seus corpos para a ciência através da juvenil Diabetes Research Foundation Islet Resource Center Consortium.
Graças a esse recurso, a equipe da EVMS confirmou que 12-LO é realmente encontrado em ilhotas humanas e nos seres humanos, como nos ratos, os seus produtos lipídicos pró-inflamatórios que podem levar à menor produção de insulina e da morte das células beta.
"Nós já confirmamos que a 12-LO é um alvo nos seres humanos, particularmente no pâncreas, e esta descoberta irá ajudar a busca de novas terapias", diz o Dr. kaiwen Ma.
"O próximo passo será desenvolver uma droga que atinge a 12-LO e combinar isso com a regeneração celular."
"Estamos atualmente trabalhando com pesquisadores da Califórnia e do Instituto Nacional de Saúde para identificar medicamentos que foquem a inibição da 12-LO como um novo tratamento para impedir danos imunes às células humanas produtoras de insulina", diz o Dr. David A. Taylor-Fishwick .
Acopanharei o desenvolvimento desta pesquisa e farei o update para todos.
Dr. Mauro

Artigo (*notice post) original em Inglês

Key to Reversing Type 1 Diabetes Discovered

The Journal of Clinical Endocrinology and Metabolism. Feb 2010
Members of a research team at the center, led by Jerry Nadler, MD, professor and chair of internal medicine and director of the center, have been studying the role of the enzyme 12-Lipoxygenase (12-LO) in the development of Type 1 diabetes. They hope that targeting this enzyme will hold the key to a cure.
Type 1 diabetes is a chronic condition that develops when the pancreas stops generating enough insulin to maintain normal levels of glucose (sugar) in the blood. Insulin moves sugar from the bloodstream to cells so that it can be used to generate energy. In Type 1 diabetes, a person's immune system attacks the insulin-producing beta cells, found only in the pancreas. When the beta cells die, the body no longer can produce enough insulin to regulate blood-glucose levels, and this can lead to serious health complications, even death, without treatment.
It is generally understood that inflammation plays a vital role in beta-cell destruction. But the precise factors are not well known. A protein-based enzyme found in beta cells, 12-LO produces specific lipids that cause inflammation and can lead to the death of beta cells in laboratory models. In fact, EVMS researchers have demonstrated that deleting the gene that produces 12-LO prevents the development of Type 1 diabetes in mice.
Dr. Nadler explains that the challenge has been to validate that 12-LO and its pro-inflammatory lipid products have a role in human diabetes. Gaining access to human beta cells can be difficult, but EVMS is among a limited number of research groups that can receive human islets -- the region of the pancreas that contains beta cells -- from individuals who have donated their bodies to science through the Juvenile Diabetes Research Foundation Islet Resource Center Consortium.
Thanks to that resource, the EVMS team has confirmed that 12-LO is indeed found in human islets, and in humans, like in mice, its pro-inflammatory lipid products can lead to lower insulin production and beta cell death.
"We've now confirmed that 12-LO is a relevant target in humans, particularly in the pancreas, and will help lead to new therapies," Dr. Kaiwen Ma says.
"That's why these new findings are so important," Dr. Swarup K. Chakrabarti says. "The next step will be to develop a drug that targets 12-LO and combine that with cell regeneration."
"We are currently working with investigators in California and the National Institutes of Health to identify ideal medications that would target 12-LO as a new treatment to halt immune damage to human insulin-producing cells," Dr. David A. Taylor-Fishwick says.

Evento da NOVA MSD em Brasília finalizado com sucesso

Encerrou hoje ao meio dia o evento da Nova MSD, denominado uma visão global nos cuidados ao paciente. O evento contou com uma excelente infra-estrutura e apresentou temas variados como gestão de pessoas, a importância do marketing e suas ferramentas e o papel das novas mídias e internet, bem como as melhores ferramentas de gestão médica. Participação excelente de Carlos Eduardo Couri em debate com plenário de cardiologistas e endocrinologistas, entre outros especialistas. Agradecimento especial a Dra. Martha Savastano, mestre em admnistração pela FGV, Ricardo Almeida, especialista em gestão de projetos WEB, professor e coordenador de MBA e Joel Dutra, professor de economia da USP.

A Sustentabilidade foi tema em foco e o evento foi coroado por um excelente debate entre os principais palestrantes, conduzido com maestria por Heródoto Barbeiro.

Parabéns a Nova MSD pelo inovador modelo de evento e pelo profissionalismo de seus profissionais envolvidos na atividade. Brasília continua linda e com uma excelente gastronomia. Espero voltar em Breve.