RESEARCH - Adult stem cells in the treatment of autoimmune diseases

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Rheumatology (Oxford). 2006 Oct;45(10):1187-93. Epub 2006 Jun 15.

Adult stem cells in the treatment of autoimmune diseases.

Department of Rheumatology, University of Basel, Felix Platter Spital,

Burgfelderstrasse 101, Basel 4012, Switzerland.

During the past 10 yrs, over 700 patients suffering from severe autoimmune

disease (AD) have received an autologous haematopoietic stem cell transplant

as treatment of their disorder with durable remission being obtained in

around one-third. The most commonly transplanted ADs have been systemic

sclerosis (scleroderma), multiple sclerosis, rheumatoid arthritis, juvenile

idiopathic arthritis and systemic lupus erythematosus. A fewer number of

patients have received an allogeneic transplant. The initially reported

overall treatment-related mortality of 7% has since fallen, with no further

cases being reported in systemic sclerosis or multiple sclerosis in the past

3 yrs. This is thought to be due to more careful patient selection.The phase

I/II data has led to currently running prospective randomised trials in

systemic sclerosis, multiple sclerosis and systemic lupus erythematosus in

Europe and North America. Immune reconstitution data suggests a 'resetting'

of autoimmunity in those patients achieving stable remission, rather than

simply prolonged immunosuppression. Recent results from in vitro

experiments, animal models and early human experience in severe acute graft

vs host disease suggest that multipotent mesenchymal stromal cells obtained

from the bone marrow and expanded ex vivo, may exert a clinically useful

immunomodulatory effect. Such cells are immune privileged and apparently of

low toxicity. Further characterization of these cells and consideration of

their possible clinical application in AD is underway.

PMID: 16777856

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16777856

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