Autoimmune Disease – Stem Cell Treatments

Stem cell treatments for blood disorders and cancers such as leukaemia have been successful for many years and rely on the destruction of the body’s own immune system- and blood-forming cells in the bone marrow. Scientists have now begun to investigate that possibility of using similar techniques in order to rid the body of autoimmune (AI) diseases and replace faulty stem cells from patients with conditions such as Rheumatoid Arthritis, Lupus, type 1 diabetes, and Sjögren’s syndrome with healthy immune system-forming stem cells. This idea of ‘resetting’ the immune system is far from simple however, as patients would be at significant risk of complication during the time that their immune system was rebuilding itself. Bone marrow transplants are used for diseases that would, otherwise, be fatal and are inadvisable for those with conditions that can be managed using conventional therapies. Researchers have managed to significantly reduce the risk of fatality with such stem cell transplants from about 10% to 1-5%, which is clearly good news for those with no other treatment option but is still a considerable risk for those with autoimmune diseases that are responding to current treatments.

Autoimmune Diseases Treated with Stem Cells

Passweg and Tyndall (2007) estimated that more than a 1000 patients with autoimmune diseases were treated with haematopoietic stem cells between 1996 and 2007. Most of these patients had Multiple Sclerosis (MS), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), or Systemic Sclerosis (SSc) and many of those treated have enjoyed long-term disease-free remissions and immune reconstitution since treatment. The likelihood or relapse following treatment appears to be related to residual lesional effector cells, with Tyndall and van Laar (2010) finding an association between incomplete, low immunoablative intensity in early conditioning and higher incidence of patient relapse. This means that the patients’ own faulty immune system effectively repopulated itself with self-reactive immune cells when only partially destroyed by initial myeloablative treatment.

MSCs to Modulate AI Disease

A more recent publication by Tyndall (et al, 2009) suggests however that evidence from further Phase I/II studies shows that mesenchymal stem cell (MSC) transplants for autoimmune diseases can act as immunomodulatory agents without the need for myeloablation of the recipient’s immune system although further research is needed. The same review highlighted movement into Phase III trials for systemic sclerosis, multiple sclerosis, and Crohn’s disease along with evidence of collagen remodelling and normalization of microvasculature following haematopoietic stem cell transplant, an important consideration in rheumatoid arthritis patients with low endothelial progenitor cell levels.

Continue –> Stem Cell Treatment of Inflammatory Autoimmune Disease