（今天抽时间翻译了这篇新闻，特意做成英汉对照，请各位高手多提宝贵意见）
25-JUN-2007
First Use Of Cord Blood To Alter Course Of Type 1 Diabetes
首次使用脐带血改变1型糖尿病治疗疗程
Yields Insights for Developing Future "Cocktail" to Treat the Disease
为研究将来的“鸡尾酒”疗法的带来了启示。
Chicago, IL (June 25, 2007) - In a small pilot study, transfusion of stored, autologous (i.e. the person?s own), umbilical cord blood into a group of children newly diagnosed with type 1 diabetes appears to have reduced their disease severity, possibly re-setting the immune system and slowing the destruction of their insulin-producing cells, according to a report presented today at the American Diabetes Association's 67th Annual Scientific Sessions.
（2007年6月25日）伊利诺斯州，芝加哥 – 根据今天在美国糖尿病协会第67届年度科技大会上的一份报告，在一个小型的实验性研究中，给刚刚诊断为1型糖尿病的一组孩子们注射了储存的自体同源（即自身的）脐带血液，看来可以减轻病情，可能会重新设定免疫系统而且能够延缓他们的胰岛素分泌细胞遭受破坏。
"After only six months, it is too early to tell how long the children will benefit from this therapy, but early signs indicate that it may have helped enhance blood glucose control and management," said Michael J. Haller, MD, Assistant Professor of Pediatric Endocrinology at the University of Florida College of Medicine and lead author of the study, in a recent interview.
在最近的一次采访中，弗罗里达医学院儿科内分泌学助理教授，医学博士，该项研究的领头人，霍尔. J. 迈克尔说：“这次研究仅仅经过了6个月，要说出孩子们会从这项疗法中受益多久还为时尚早，但是早期的迹象表明，它可以帮助改善血糖控制和管理。”
"But more important than the potential benefit in these children, this first use of cord blood in diabetes will help us focus on what it is in the cord blood that yielded the benefit," he said. "We then hope to isolate and grow that cell type to develop therapies for a larger pool of people, not just those who have stored cord blood." He discussed how such a cellular therapy might be one component of a future immune-modulating "cocktail."
“比起这项疗法对孩子们的潜在的好处，更重要的是，首次在糖尿病治疗中使用脐带血将有助于我们集中研究：是脐带血中的什么成分产生的这些好处，”他还说：“然后，我们希望把那种细胞分离出来进行培养从而研究出可以适用于更大群体的病人，而不是仅仅用于那些已经储存脐带血的病人。”他还论述了，这种细胞疗法怎样可能会成为将来免疫调节“鸡尾酒疗法”的一个组成部分。
Nearly 21 million Americans have diabetes, a group of serious diseases characterized by high blood glucose levels that result from defects in the body's ability to produce and/or use insulin. Diabetes can lead to severely debilitating or fatal complications, such as heart disease, blindness, kidney disease, and amputations. It is the fifth leading cause of death by disease in the U.S.
近21,000,000美国人患有糖尿病，这是一个严重疾病群体，特点是由于自身在产生和/或利用胰岛素能力受到破坏而导致的高血糖。糖尿病可以导致严重的虚弱或致命性并发症，如心脏病，失明，肾病和截肢，在美国由于疾病一起的死亡中糖尿病是第5大主要病因。
Type 1 diabetes is an immune-mediated disease that involves a failure of the body?s immune system to recognize cells - its "self" - as non-threatening (called a failure of "tolerance"), leading to progressive destruction of the insulin-producing beta cells in the pancreas. Type 1 diabetes usually strikes children and young adults, although disease-onset can occur at any age.
1型糖尿病是一种免疫力引起的疾病，它是由于自身的免疫系统不能把它自身细胞 – 它“自己” - 当作非威胁性的细胞（叫做“容许”失败），从而导致胰腺中分泌胰岛素的BETA细胞受到破坏。1型糖尿病通常发生在儿童和青少年身上，尽管在任何年龄都有可能发病。
STUDY METHODOLOGY AND RESULTS
研究方法和结果
The researchers recruited seven young (age 2 to 7 years at the time of infusion) children with type 1 diabetes who had their own stored cord blood and infused them with it. This group was matched with 13 randomly selected youngsters of similar age and diabetes duration who had been intensively treated with insulin and served as a control group.
研究人员召集了7个1型糖尿病小孩（在注射脐带血的时候2到7岁），他们储存有脐带血，给他们注射了脐带血。与该组对应的另外一组是由13名随意挑选的相近年龄、相近病程的孩子组成，这一组孩子采用的是胰岛素强化治疗，称为控制组。
A1C tests and total daily insulin use from diagnosis to six months after infusion were compared. (A1C is a measure of blood glucose control over a two- to three-month period.)
比较了注射脐带血后从诊断到六个月的A1C试验结果和每日胰岛素用量。（A1C是两三个月的平均血糖水平。）
Over the six-month period there was little change in the stimulated C-peptide values of the group, indicating that they may have had retention of endogenous insulin production longer than expected for young children.
在6个月期间，组里的受激C-肽值没有什么改变，表明他们可以使孩子保持自身胰岛素产生的时间超过预期的时间。
"Because of the cord blood infusion, these youngsters may retain endogenous insulin production for a longer period," said Dr. Haller. "Therefore, they may be at lower risk for diabetes complications over the length of their lifetime, as was demonstrated by the groundbreaking Diabetes Control and Complications Trial."
霍尔博士说：“由于注射了脐带血，这些孩子自身产生胰岛素的时间可以保持得更长，因此，在他们有生之年发生并发症的危险性就会更低，因为这个经过了改进的糖尿病控制和并发症试验的证明。
No adverse events associated with the transfusions were observed.
没有发现与注射相关的任何副作用。
CONCLUSIONS 结论
"Our preliminary data showing lower A1Cs, lower average insulin requirements, and possible preservation of C-peptide suggest a beneficial effect of autologous umbilical cord transfusion in youngsters with recent onset type 1 diabetes," said Dr. Haller. "Considerable research today is seeking to delay complete beta cell loss, and this may be one effective approach for children who have their own cord blood, who are newly diagnosed with type 1, and who enter clinical trials." However, he emphasized that it would be costly and inefficient for everyone to save their cord blood as a possible type 1 therapy. Therefore, the goal is to determine the factor in the cord blood that is yielding the benefit.
“我们的初步数据显示，A1C水平较低，平均胰岛素需求较低以及对C肽的潜在的保护作用，这些表明给刚刚发病的1型糖尿病患儿注射自体同源脐带血是大有裨益的。当今大量的研究旨在寻求推延整体的BETA细胞的损失，因此该方案可能成为保留有自身脐带血的、刚刚诊断为1型糖尿病的、进入临床试验的患儿的有效治疗方法。”但是，他强调说，让每个人把他们的脐带血保留下来作为可能的1型治疗方案是昂贵的也是不可能的，因此目标是确定脐带血中产生有益作用的成分。
POSSIBLE MECHANISMS 可能的组成部分
Desmond A. Schatz, MD, Professor and Associate Chairman of Pediatrics at the University of Florida College of Medicine and senior author of the study, posited three potential mechanisms for the results in a recent interview.
弗罗里达医学院小儿科医学博士，教授，助理主席以及该研究的资深发起人，Desmond A. Schatz博士在最近的一次采访中对结果提出了三种可能的组成成分。
"While cord blood contains stem cells capable of differentiating into insulin-producing cells, and infused cells could have stimulated islets to regenerate, it is most likely that infused regulatory T cells, known to be able to induce autoimmune tolerance, may have prompted a type of immune regulation," he said.
他说：“只要脐带血包含有能够分离成产生胰岛素细胞的干细胞，注射的细胞就会刺激胰岛再生，很有可能是注射的调节性T细胞，这种细胞能够引发自身免疫系统的容许作用，这样就可以促进一种免疫调节。”
"We think that cord blood is a very rich source of these regulatory T cells, and there was a measurable increase in these cells in patient?s blood through six months after the infusion," said Dr. Schatz. "While we have not followed the participants long enough to determine how long these benefits will last, the improvement in blood glucose control appears to be related to the infusion of these cord blood cells." The youngsters will continue to be followed long term.
Schatz博士说：“我们认为脐带血富含这些调节性T细胞，而且在注射后六个月内可以测到这些细胞数量在增长。由于我们未能对参与者进行足够长时间的跟踪，因此还未能确定这些有益作用会持续多久，血糖控制的改善看来与注射这些脐带血细胞有关。”还将继续对这些孩子进行长期跟踪。
While this study does not confirm a specific advantage for any particular type of cell therapy, it argues strongly in favor of expanded studies to better characterize any source of regulatory T cells (also known as T regs) that may eventually be used in type 1 diabetes.
由于该项研究不能对任何一种细胞疗法的具体优势进行确认，因此强烈提出进行扩展性研究以便更好地发现调节性T细胞的任何源头（也可以称为T regs），这些调节性T细胞最终可能会应用于治疗1型糖尿病。
"Transfusing the cord blood may provide a bolus of T regs, a type of immune cell that can keep the immune system from attacking the pancreas," said Dr. Haller. Based on the changes observed at six months, the researchers think the T regs may restrain the immune system.
霍尔博士说：“注射脐带血细胞可以提供一个大剂量的T调节细胞，这是一种可以保护胰腺免受免疫系统攻击的免疫细胞。”根据在六个月中观察到的变化，这些研究人员认为T调节细胞可以抑制免疫系统。
"The idea of restoring tolerance is the holy grail of autoimmune research, and would make it possible to arrest and perhaps even prevent the development of diabetes," he explained. "Our theory is that T regs are one of the key factors yielding benefit in cord blood," he explained. "Eventually we might be able to take T regs out of cord blood in order to have a source from which to grow more."
他解释说：“重建免疫系统容许功能的理念时候自身体免疫研究中梦寐以求的一步，重建免疫系统的容许功能可能会阻止，甚至可能会预防糖尿病的发病。我们的理论是T调节细胞是脐带血中产生有益作用的关键因素之一。最终，我们可能会把T调节细胞从脐带血中提取出来作为培养源以便生成更多的T调节细胞。”
"The type 1 diabetes disease process may be altered with T regs plus a mild immunosuppressive or other immunomodulating drug or additional cell therapy, which is called "cocktail therapy," in a manner similar to the breakthroughs made in treating HIV and cancer," said Dr. Heller.
霍尔博士说：“采用T调节细胞加上适量的免疫抑制剂或其它免疫调节药物或者其它的细胞疗法可能可以改变1型糖尿病病程，这就叫做“鸡尾酒疗法”，这种疗法与治疗艾滋病和癌症上的突破性疗法相似。
"We feel a cautious optimism for a role for cellular therapies in altering the natural history of type 1 as it relates to ameliorating the disease or preventing the disease, likely in combination with other agents," said Dr. Schatz.
Schatz博士说：“对于细胞疗法在改变1型糖尿病自然病程的作用，我们抱着谨慎乐观的态度，因为它牵涉到改善或预防疾病，可能要与其他机构联合研究。”
An editorial in the Journal of the American Medical Association in April 2007 on another approach to cellular therapy to interdict type 1 diabetes noted that umbilical cord cells are one of the many sources of such cells under consideration, as well as T-regulatory lymphocytes, embryonic or adult stem cells, and dendritic cells. The editorialist suggested that "Research in this field is likely to explode in the next few years?" and that "The time may indeed be coming for starting to reverse and prevent type 1."1
2007年4月份美国医学协会期刊的一篇关于另外一种阻断1型糖尿病病程的细胞疗法的社论指出，脐带血细胞是这些细胞考虑范围内的许多来源之一，还有T-调节性淋巴细胞，克隆或成人干细胞，以及枝状细胞。社论主编提出：“在该领域的研究在以后几年内迅猛发展，开始逆转和预防1型糖尿病的时间可能真的要到来了”。
Co-authors with Drs. Haller and Schatz were Mark Atkinson, PhD; Hilla-Lee Viener, BS; Todd Brusko, PhD; Clive Wasserfall, MS; Kieran McGrail, BS; Susan Staba, MD; and Chris Cogle, MD, all of the University of Florida College of Medicine.
与霍尔和Schatz博士的一起的合作研究人员有Mark Atkinson, 医学博士；Hilla-Lee Viener, 外科学士；Todd Brusko, 医学博士；Clive Wasserfall, 外科硕士; Kieran McGrail, 外科学士; Susan Staba, 医学博士; 和 Chris Cogle, 医学博士，他们都来自弗罗里达医学院。
The American Diabetes Association is the nation's leading voluntary health organization supporting diabetes research, information and advocacy. Founded in 1940, the Association has offices in every region of the country, providing services to hundreds of communities.
For more information, please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit
www.diabetes.org. Information from both these sources is available in English and Spanish.
Abstracts #313-OR and #314-OR
2007
