Clinical study of stem cells in autoimmune diseases

2022-06-04 0 By

Autoimmune diseases (ADs) : refers to tissue damage caused by the immune response of the body to its own antigens, which can also cause peripheral and central immune tolerance abnormalities.Autoimmune T cells and T cells give rise to B cells, resulting in tissue damage and loss of function.So far, more than 80 kinds of autoimmune diseases have been found, and many common diseases are autoimmune diseases.Severe autoimmune diseases include multiple sclerosis (MS), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Crohn’s disease (CD), and juvenile idiopathic arthritis (JIA).As we all know, autoimmune diseases are mostly refractory diseases, and the existing treatment methods (mainly hormone therapy, with large toxic and side effects) can only control the progress of these diseases or alleviate symptoms, but basically cannot completely cure them.00-1010 Hematopoietic stem cell transplantation (HSCT) is very important.HSCT is used for the treatment of AD and is designed to kill autoimmune cells and perform self-tolerant immune reconstitution.The European Society of Blood and Bone Marrow Transplantation (EBMT) has registered more than 3000 clinical studies of HSCT in the treatment of various serious ADS diseases.For autoimmune diseases, hematopoietic stem cells (HSCT) may play a role in the pathogenesis of autoimmune diseases.The main mechanisms are as follows: From lymphocytopenia and the role of thymogenesis in immune reconstitution: Studies in The Journal of Immunology have shown that T cell reconstitution after transplantation is caused by lymphocyte depletion.During lymphocytopenia, exogenous T cell proliferation can be promoted by stimulation with enlarged cytokines and stable antigens.Role of regulatory T cells in immune reestablishment: Studies have shown that regulatory T cells play an important role in preventing disease recurrence in a mouse model of proteoglycan induced arthritis, and that T cells, as a source of grafts, have the potential to improve immune suppression.Multiple sclerosis (MS) : Multiple sclerosis is an inflammatory disease of the central nervous system.Local inflammation of nerve cells in the brain and spinal cord leads to demyelination damage, which further inhibits the ability of axons to transmit and transmit signals between nerve cells, causing permanent damage.A Swiss study found that of 48 patients with multiple sclerosis treated with HSCT, 41 had a median follow-up of 47 months, 87% were relapse-free within 5 years and MRI event-free survival was 85%.The Extended Disability Rating Scale (EDSS) showed a 77% progression-free survival rate, 68% relapse-free survival rate, and treatment-related death.Systemic sclerosis (SSc) : SSc is a disease characterized by inflammation, diffuse vascular disease, and a variety of visceral hyperfibrosis.To date, HSCT has become the routine treatment of choice for SSc.156 SSc patients from 10 countries were included in the international scleroderma study of EBMT stem cell transplantation.The results showed that there were no adverse events within 4 years in the HSCT group and the overall survival rate was improved.Systemic lupus erythematosus (SLE) : Systemic lupus erythematosus is a connective tissue autoimmune inflammatory disease, often affecting young women and involving multiple organs.It is characterized by high morbidity and mortality and complex pathogenesis.The EBMT/ Northwestern study showed that patients with systemic lupus erythematosus had a 50% 5-year inactive survival rate after HSCT.In the study of Ling et al, 27 patients with severe SLE who received treatment were collected and 24 effective cases were eventually included, including 21 cases in remission at 6 months after transplantation, with an overall survival rate of 86% at 10 years and survival rate at remission.Among 22 patients with SYSTEMIC lupus erythematosus who received HSCT, 3-year progression-free survival rate was 77.27%, 5-year progression-free survival rate was 67.9%, and overall survival rate was 95.2%.Respectively.Crohn’s disease (CD) : This disease is an autoimmune inflammatory bowel disease, the pathogenesis is not clear.In this study, 45 patients with refractory CD were randomly divided into HSCT group (n = 23) and stem cell mobilization group (n = 22), and treated with standardized HSCT regimen.Two patients in the HSCT group met the strict criteria for sustained response, while only one patient in the control group achieved an overall response, but 14 patients (60.9%) achieved sustained response.Rheumatoid arthritis is characterized by synovitis and progressive joint destruction.At present, there is a study on the activity of 14 RA patients, and it is found that after receiving HSCT treatment, the mobility and joint function of index patients are improved, and 28% of patients have no effective progressive survival after 3 years of follow-up, indicating that HSCT treatment has a good effect.According to statistics, of the 16 JIA patients treated between 2007 and 2016, 14 survived with normal blood observation and significant improvement in arthritis symptoms.In addition, there are many related cases.With the development of research and application, stem cells are becoming more and more effective in autoimmune diseases.Stem cell technology is destined to become a new therapeutic method to aid in the recovery of autoimmune diseases.