The human blood is, probably, one of the greatest gifts we can give to other people— or even to ourselves. It helps our body to function normally, and for patients, blood is the safety rope that they hold on to for their dear life. Some medicines may come and go, but blood supplies (as long as there are willing blood donors and ongoing blood donations) will always be there.
Speaking of blood, an umbilical cord— which is clamped and cut after birth— is packed with nutritious blood and placenta that can also help millions of patients in need. Over the years, stored cord blood has been used for scientific researches that have been proven to have significant contribution to the medical field. For example, stem cells from cord blood have been tested and converted into nerve cells, which is a groundbreaking event not only for researchers, but also for people who will need it in the future.
Unfortunately, some umbilical cords are being disposed of after birth, with all the nutrients and important placenta being thrown away with it.
Fortunately, there is a new discovery from the field of science that may change mothers’ minds about throwing their umbilical cord away after birth.
ISLA AND THE DIABETES FIGHT
On May 27, Isla Robinson, a four-year old Australian girl, made scientific history by becoming the very first person in the whole world to be injected with her own cord blood for the prevention of her own illness— specifically type 1 diabetes.
Little Isla, whose body has been detected to have more than two antibodies that could increase her chance of developing type 1 diabetes, is one of the 20 children (and, actually, the first) who are scheduled to undergo cord blood transfusion in Australia. This is for a study led by Associate Professor Maria Craig, a pediatric endocrinologist at the Children’s Hospital in Westmead, Sydney, and sponsored by Cell Care, the country’s largest cord blood bank.
Isla’s mother, Rachel Weldon, decided to bank the child’s cord blood in Cell Care in 2011, which has proven the decision to be a good idea four years later. “It just seemed like a good insurance policy, I suppose,” she said.
After Isla’s siblings were diagnosed with type 1 diabetes, with her sister Ruby being the latest, she has been taking tests every six months for the past three years. After having three harmful antibodies, she was subject to transfusion of her own cord blood, in the hopes of preventing or delaying the disease from developing inside her body.
“All the studies suggest she will actually develop it one day, so if we can stop that it would be fantastic,” Craig said. “I’m hoping we can completely switch off that autoimmune process and she will never get it.”
The study is still ongoing, and with the 19 other patients who will undergo cord blood transfusion, there is still hope that this fascinating procedure would eventually work.
INSIDE THE INFUSION
So, how does this new medical study actually work?
In a formal sense, the procedure has two phases: the screening phase and the treatment phase.
First Phase: Screening
For the first part, participants (or the 20 young patients selected out of the 600 Australian children with cord blood banked in Cell Care, the sponsor of the study) will be tested for Insulin, GAD, ZnT8 and IA2 autoantibodies. The medical team, led by Craig, will also measure their random glucose and hemoglobin A1c levels.
If, unfortunately, two or more antibodies to islet antigens are detected, then the patient will proceed to the treatment phase.
The reason for this is because the presence of more than one antibody could mean a higher risk of type 1 diabetes development, so the patient will need further examination if ever this case occurs.
Second Phase: Treatment
The next phase of the study involves a more in-depth treatment.
For the second part, patients will be getting single intravenous infusion of autologous cord blood, which contains >5 x 106 total nucleated cells per kilograms recipient body weight. This cord blood will be infused to the patient for about one hour.
If negative antibodies are detected, then the patient will be subject to repeat screening in a course of 12 months.
In Isla’s case, the donated cord blood from her umbilical cord four years ago underwent various steps before being re-infused inside her body.
Cryoprotective agents have been added to her cord blood for storage purposes, and then on the day of the transfusion, it was defrosted, washed, and diluted.
The re-infusion took about half an hour, and for safety reasons, Isla was given a mild antihistamine and antibiotics before the transfusion.
This is a great advancement in the field of health and medicine, but according to Craig, it is possible that cord blood is not really the cure to type 1 diabetes.
For example, in Isla’s case, the cord blood treatment may not be the permanent cure for her possible type 1 diabetes. Instead, the high amount of T-cells (or Tregs, a kind of immune cells) in the blood could only delay the time when she actually develops the illness.
“It could be many years while it dampens down her immune response,” Craig stated.
However, she expressed that the delay in Isla’s development of type 1 diabetes would be a fine opportunity for them to try more effective studies and experiments.
“Even if it could delay it to adolescence, until she is older, that would be fantastic because that also buys us time for other therapies that are being developed,” she said.
HOPE FOR DIABETIC KIDS
The cord blood, which is proven to be abundant in immune cells and other vital nutrients, is believed to help children with possible type 1 diabetes (like Isla). These cells can possibly reboot their immune system and completely prevent the disease from landing in their body forever.
Branches of this study are still ongoing around the world. For example, in Bavaria, Germany, children with T1D are being re-infused of their own cord blood to test if insulin-producing cells in the pancreas can be regenerated. The research team which is in-charge for this is also studying the effects of cord blood in metabolism change and immune function, which leads to islet regeneration.
Little by little, the silver lining for people— especially children— with T1D is now showing itself for the whole world to see and feel.