This experiment was started in 2007. People who had type-1 diabetes for more than 5 years were treated by removing dentric cells, treating those cells, and then reinjecting them. This was done 4 times (2 weeks apart). About 10 people were treated, but there was no placebo group. This study was a phase-I trial, very clearly aimed at safety, not effectiveness. As far as I know, this is the first clinical trial aimed at type-1 diabetes, which used this basic method (of reinjecting a patient's specially treated dendric cells). So there were new and unique safety issues to be tested. Just recently a second study using this same basic technique has started which you can read about here:
http://cureresearch4type1diabetes.blogspot.com/search/label/Polyclonal%20Tregs
This is from the abstract:
CONCLUSIONS Treatment with autologous dendritic cells, in a native state or directed ex vivo toward a tolerogenic immunosuppressive state, is safe and well tolerated. Dendritic cells up regulated the frequency of a potentially beneficial B220+ CD11c− B-cell population, at least in type 1 diabetes autoimmunity.My translation is is this:
First, there were no safety issues. The treatment's safety was good.
Second, there were some effects (which they think are good) on a particular type of B-cell.
Third, there were no other effects seen (so no changes in C-peptide levels, A1c, or T-cells, for example).
What does this mean?
The most important results, is that the treatment is undoubtedly safe enough to continue into phase-II trials. (In the presentation below there is a letter from the FDA saying that.)
But after that, did it work? Very hard to tell, but it did not work as measured in the obvious ways by raising C-peptide levels, for example, or lowering antibody levels. The researchers hope that the change in B cells is a good sign, but I'm not sure that it is.
It is important to remember that B-cells and T-cells come in all different types. So when these researchers say B220+ CD11c− B-cells they are referring to one type specifically. They hope that more B-cells of that specific type are a good thing, but this trial alone does not show that is so. For comparison, the most talked-about type of B cell is called CD20. T cells that are researched as part of type-1 research include CD4 and CD8 (and many more). I know of no other clinical trials working with this type of B-cell.
Abstract: http://care.diabetesjournals.org/content/34/9/2026.short
Presentation: http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/OnlineBooks/Documents/Keystone2011/Keystone%202011%20Trucco%20Cellular%20Therapies.pdf
Clinical Trial Record: http://clinicaltrials.gov/show/NCT00445913
Joshua Levy
All the views expressed here are those of Joshua Levy, and nothing here is official JDRF or JDCA news, views, policies or opinions. My blog contains a more complete non-conflict of interest statement.
Blog: http://cureresearch4type1diabetes.blogspot.com
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