School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
Med J Aust. 2013 Aug 19;199(4):288-99. doi: 10.5694/mja12.10835.
• Type 1 diabetes results from the loss of normal immunological self-tolerance, which may be attributable to the failure of Foxp3+ regulatory T cells (Tregs). Umbilical cord blood is rich in Tregs and therefore has the potential to prevent or delay the onset of type 1 diabetes. A pilot trial is currently underway in Australia to examine whether infusion of autologous cord blood can prevent type 1 diabetes in high-risk children with serum antibodies to multiple β-cell antigens. • A number of other potential therapeutic indications for autologous cord blood have been proposed, including cerebral palsy and hypoxic-ischaemic encephalopathy. • Recruitment to clinical trials using cord blood is influenced by divergent public and private cord blood banking policy in Australia. The burgeoning consumer demand for storage of cord blood highlights the need for regulatory bodies to develop and adapt policies to facilitate research that may extend the use of cord blood beyond currently recognised indications. • Consumers, researchers and policymakers must also recognise specific ethical issues associated with collection and storage of cord blood, including storage in public and private banks, informed consent, ownership, access and the principle of beneficence.
• 1 型糖尿病是由于正常免疫耐受丧失引起的，这可能归因于 Foxp3+调节性 T 细胞（Tregs）的缺失。脐带血富含 Tregs，因此具有预防或延迟 1 型糖尿病发病的潜力。目前澳大利亚正在进行一项试点研究，以检验输注自体脐带血是否可以预防对多种β细胞抗原具有血清抗体的高危儿童发生 1 型糖尿病。• 已经提出了脐带血的其他一些潜在治疗适应证，包括脑瘫和缺氧缺血性脑病。• 澳大利亚公共和私人脐带血库政策的差异影响了使用脐带血进行临床试验的招募。消费者对储存脐带血的旺盛需求凸显了监管机构制定和调整政策的必要性，以促进可能使脐带血的用途超出目前公认适应证的研究。• 消费者、研究人员和政策制定者还必须认识到与脐带血采集和储存相关的特定伦理问题，包括在公共和私人银行中的储存、知情同意、所有权、获取和行善原则。
