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Made to Measure: Patient-Tailored Treatment of Multiple Sclerosis Using Cell-Based Therapies. Int J Mol Sci 2021; 22:ijms22147536. [PMID: 34299154 PMCID: PMC8304207 DOI: 10.3390/ijms22147536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022] Open
Abstract
Currently, there is still no cure for multiple sclerosis (MS), which is an autoimmune and neurodegenerative disease of the central nervous system. Treatment options predominantly consist of drugs that affect adaptive immunity and lead to a reduction of the inflammatory disease activity. A broad range of possible cell-based therapeutic options are being explored in the treatment of autoimmune diseases, including MS. This review aims to provide an overview of recent and future advances in the development of cell-based treatment options for the induction of tolerance in MS. Here, we will focus on haematopoietic stem cells, mesenchymal stromal cells, regulatory T cells and dendritic cells. We will also focus on less familiar cell types that are used in cell therapy, including B cells, natural killer cells and peripheral blood mononuclear cells. We will address key issues regarding the depicted therapies and highlight the major challenges that lie ahead to successfully reverse autoimmune diseases, such as MS, while minimising the side effects. Although cell-based therapies are well known and used in the treatment of several cancers, cell-based treatment options hold promise for the future treatment of autoimmune diseases in general, and MS in particular.
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Wen R, Dong C, Xu C, Zhao L, Yang Y, Zhang Z, Chen Y, Duan L, Chen H, Yang Z, Zhang B. UM171 promotes expansion of autologous peripheral blood hematopoietic stem cells from poorly mobilizing lymphoma patients. Int Immunopharmacol 2020; 81:106266. [PMID: 32062079 DOI: 10.1016/j.intimp.2020.106266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Autologous hematopoietic stem cell transplantation is an effective therapeutic strategy for lymphoma patients. However, some patients have to give up receiving transplantation because of failing to obtain sufficient CD34+ cells yields. Therefore, we ex vivo expanded HSCs of lymphoma patients using UM171 to solve the problem of HSCs deficiency. METHODS Mobilized peripheral blood-derived CD34+ cells from lymphoma patients were cultured for 10 days with or without UM171. The fold of cell expansion and the immunophenotype of expanded cells were assessed by flow cytometry. RNA-seq experiment was performed to identify the mechanism by which UM171 promoted HSCs expansion. RESULTS UM171 treatment increased the proportion of CD34+ (68.97 ± 6.91%), CD34+ CD38- cells (44.10 ± 9.20%) and CD34+CD38-CD45RA-CD90+ LT-HSCs (3.05 ± 2.08%) compared to vehicle treatment (36.08 ± 11.14%, 18.30 ± 9.49% and 0.56 ± 0.45%, respectively). UM171 treatment led to an 85.08-fold increase in LT-HSC numbers relative to initial cells. Importantly, UM171 promoted expansion of LT-HSCs achieved 138.57-fold in patients with poor mobilization. RNA-seq data showed that UM171 upregulated expression of HSC-, mast cell-specific genes and non-canonical Wnt signaling related genes, and inhibited genes expression of erythroid, megakaryocyte and inflammatory mediated chemokine. CONCLUSIONS Our study shows that UM171 can efficiently promote ex vivo expansion of HSCs from lymphoma patients, especially for poorly mobilizing patients. In terms of mechanism, UM171 upregulate HSC-specific genes expression and suppress erythroid and megakaryocytic differentiation, as well as activate non-classical Wnt signaling.
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Affiliation(s)
- Ruiting Wen
- Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, PR China; Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Chen Dong
- Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, PR China; Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Chen Xu
- Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, PR China; Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Long Zhao
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Yang Yang
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Zhihua Zhang
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Yanfu Chen
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Lian Duan
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China
| | - Hu Chen
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Zhigang Yang
- Department of Hematology and Rheumatology, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang 524045, PR China.
| | - Bin Zhang
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China.
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Zhu J, Hao SG, Hu J, Zhuang JL, Wang C, Bai HT. rhTPO combined with chemotherapy and G-CSF for autologous peripheral blood stem cells in patients with refractory/relapsed non-Hodgkin's lymphoma. Cancer Manag Res 2019; 11:8371-8377. [PMID: 31571993 PMCID: PMC6750872 DOI: 10.2147/cmar.s219242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/19/2019] [Indexed: 11/23/2022] Open
Abstract
Objective The mobilization and collection of sufficient autologous peripheral blood stem cells (APBSCs) are important for the fast and sustained reconstruction of hematopoietic function after autologous transplantation. This study aims to evaluate the mobilization effect and safety of thrombopoietin (TPO) combined with chemotherapy + G-CSF for APBSCs in patients with refractory/relapsed non-Hodgkin’s lymphoma. Methods A total of 78 patients were included in the present study. After receiving mobilization chemotherapy, all patients were randomly divided into two groups: TPO group (n=40), patients were given subcutaneous injection of rhTPO + G-CSF, and control group (n=38), patients were given subcutaneous injection of G-CSF. The primary endpoint was the total number of obtained CD34+ cells. The secondary endpoints were the mononuclear cell count, the proportion of target and minimum mobilization, the engraftment time of neutrophils and platelets after APBSCT, the number of platelet and red blood cell infusions, the incidence of infectious fever and fever duration, and TPO-related side effects in patients. Results TPO participation significantly increased the total CD34+ cell count. A higher proportion of patients in the TPO group achieved the minimum and target CD34+ cells, when compared to the control group. TPO-related adverse events were not observed in either of these groups. In addition, there were no significant differences in engraftment time, the number of platelet and red blood cell transfusions, the incidence of infectious fever, and fever duration between these two groups. Conclusion TPO combined with chemotherapy + G-CSF can safely and effectively enhance the mobilization effect for APBSCs in patients with refractory/relapsed non-Hodgkin’s lymphoma.
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Affiliation(s)
- Jun Zhu
- Department of Haematology, Shanghai General Hospital, Shanghai 200080, People's Republic of China
| | - Si-Guo Hao
- Department of Haematology, Shanghai Jiaotong University Affiliated Xinhua Hospital, Shanghai 200092, People's Republic of China
| | - Jiong Hu
- Department of Haematology, Shanghai Jiaotong University Affiliated Ruijing Hospital, Shanghai 200020, People's Republic of China
| | - Jing-Li Zhuang
- Department of Haematology, Fudan University Affiliated Zhongshan Hospital, Shanghai 200032, People's Republic of China
| | - Chun Wang
- Department of Haematology, Shanghai General Hospital, Shanghai 200080, People's Republic of China
| | - Hai-Tao Bai
- Department of Haematology, Shanghai General Hospital, Shanghai 200080, People's Republic of China
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Hematopoietic Progenitor Cell Mobilization for Autologous Stem Cell Transplantation in Multiple Myeloma in Contemporary Era. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:200-205. [DOI: 10.1016/j.clml.2018.12.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 11/21/2022]
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López-Castaño F, Manresa P, Díaz V, Arranz E, López J, Pérez M, Alda O, Hernández L. Comparison and cost analysis of three protocols for mobilization and apheresis of haematopoietic progenitor cells. J Clin Apher 2019; 34:461-467. [PMID: 30817045 DOI: 10.1002/jca.21699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/16/2019] [Accepted: 02/18/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Autologous bone marrow transplantation is a component of the malignant hemopathy therapy. The preferred mobilization and collection method is apheresis. The aim of this study is to compare three protocols analyzing the effect of plerixafor, higher dose of G-CSF and large volume leukapheresis (LVL). MATERIALS AND METHODS A retrospective cohort study including 119 patients referred for mobilization. Three protocols were compared: (a) G-CSF 10 μg/kg/day subcutaneous (sc) × 4 days mobilizing 1 to 1.5 blood volumes. (b) G-CSF 10 μg/kg/day sc × 4 days + plerixafor 0.24 mg/kg/day sc preventively or as a rescue agent mobilizing 1 to 1.5 blood volumes. (c) G-CSF 20 μg/kg/day sc × 4 days ± plerixafor 0.24 mg/kg/day sc preventively or as a rescue agent mobilizing 3 to 4 blood volumes. RESULTS The average number of days of apheresis was reduced to 1.37 with protocol 3. The average cost per patient was reduced by 67% compared with protocol 2 and increased by only 5% compared with protocol 1, reducing the failure rate to 0%. CONCLUSION Adding preemptive or rescue plerixafor (protocol 2) to G-CSF 10 μg/kg/day alone (protocol 1) did not improve the days of apheresis nor the number of CD34+ cells collected but had higher cost and failure rate. Using LVL, plerixafor and G-CSF 20 μg/kg/day (protocol 3) decreased the number of sessions to 1.37, reduced the failure rate to 0% and led to a significant increase in the number of CD34+ cells collected without toxicity and with a similar cost to protocol 1.
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Affiliation(s)
- Francisco López-Castaño
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - Pablo Manresa
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - Vanesa Díaz
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - Eva Arranz
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - Javier López
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - María Pérez
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - Olga Alda
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
| | - Luis Hernández
- Department of Hematology, Hospital General Universitario de Alicante (institution where the work was performed), Alicante, Spain
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Matsue K, Kumagai K, Sugiura I, Ishikawa T, Igarashi T, Sato T, Uchiyama M, Miyamoto T, Ono T, Ueda Y, Kiguchi T, Sunaga Y, Sasaki T, Suzuki K. Plerixafor for mobilization and collection of haematopoietic stem cells for autologous transplantation in Japanese patients with non-Hodgkin lymphoma: a randomized phase 2 study. Int J Hematol 2018; 108:524-534. [DOI: 10.1007/s12185-018-2505-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 11/29/2022]
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Kado M, Tanaka R, Arita K, Okada K, Ito-Hirano R, Fujimura S, Mizuno H. Human peripheral blood mononuclear cells enriched in endothelial progenitor cells via quality and quantity controlled culture accelerate vascularization and wound healing in a porcine wound model. Cell Transplant 2018; 27:1068-1079. [PMID: 29974793 PMCID: PMC6158547 DOI: 10.1177/0963689718780307] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The transplantation of endothelial progenitor cells (EPCs) is used to promote wound angiogenesis. In patients with chronic wounds and accompanying morbidities, EPCs are often compromised in number and function. To overcome these limitations, we previously developed a quality and quantity controlled (QQ) culture system to enrich peripheral blood mononuclear cells (PBMNCs) in EPCs. To evaluate the wound healing efficacy of mononuclear cells (MNCs) harvested after QQ culture (QQMNCs), preclinical studies were performed on large animals. MNCs harvested from the blood of healthy human subjects were cultured in the presence of angiogenic cytokines and growth factors in a serum-free medium for 7 days. A total of 5 × 106 QQMNCs per full-thickness skin defect or control saline was injected into wounds induced in cyclosporine-immunosuppressed pigs. EPC colony-forming assays revealed a significantly higher number of definitive (partially differentiated) EPC colony-forming units in QQMNCs. Flow cytometry evaluation of QQMNC surface markers showed enrichment of CD34+ and CD133+ stem cell populations, significant reduction in CCR2+ cell percentages, and a greater than 10-fold increase in the percentage of anti-inflammatory M2-type macrophages (CD206+ cells) compared with PBMNCs. Wounds treated with QQMNCs had a significantly higher closure rate. Wounds were harvested, frozen, and sectioned at day 21 postoperatively. Hematoxylin and eosin staining revealed that the epithelization of QQMNC-treated wounds was more advanced than in controls. Treated wounds developed granulation tissue with more mature collagen and larger capillary networks. CD31 and human mitochondrial co-staining confirmed the presence of differentiated human cells within newly formed vessels. Real-time polymerase chain reaction (PCR) showed upregulation of interleukin 6 (IL-6), IL-10, and IL-4 in the wound bed, suggesting paracrine activity of the transplanted QQMNCs. Our data demonstrate for the first time that QQ culture of MNCs obtained from a small amount of peripheral blood yields vasculogenic and therapeutic cells effective in wound healing.
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Affiliation(s)
- Makiko Kado
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Rica Tanaka
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kayo Arita
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kayoko Okada
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Rie Ito-Hirano
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Satoshi Fujimura
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroshi Mizuno
- 1 Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
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The effects of lower CD34 yields after lowe dose G-CSF induction on long-term autologous stem cell transplantation outcome: A single center study. Transfus Apher Sci 2018; 57:265-271. [PMID: 29605509 DOI: 10.1016/j.transci.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 12/15/2022]
Abstract
Peripheral blood stem cell transplantation (PBSCT) is an effective treatment for hematological malignancies. Mobilization of peripheral blood stem cells performs in different ways among transplantation centers. Since the Effects of lower CD34+ cells dose after low dose G-CSF induction on autologous stem cell transplantation outcomes are not studied much, so this study was performed for this purpose. 735 autologous stem cell transplanted patients with diagnoses of multiple myeloma (n = 330), Hodgkin lymphoma (n = 200), non-Hodgkin lymphoma (n = 129), acute myeloid leukemia (n = 54) and solid tumors (n = 22) were retrospectively evaluated. G-CSF was administered at the dose of 5 μg/kg/day during mobilization and all patients except acute myeloid leukemia received 10 μg/kg/day on the last day. Peripheral blood stem cells were harvested in one session for all patients. The amount of injected CD34+ cells/kg for patients were divided and studied in four groups: <0.5 × 106 (n = 36), 0.5-1.0 × 106, (n = 132), 1.0-2.0 × 106 (n = 226) and >2.0 × 106 (n = 305). The median time of follow up was 26.9 months. The amount of CD34+ cells dose were a significant predictor of platelet engraftment, but overall survival, relapse-free survival and also relapse rate was not associated with cells yield. More platelet transfusion (P = 0.003) and antibiotics prescription (P = 0.001) in transplanted patients with lower CD34 cells dose should be balanced with risks of higher G-CSF doses administration and also its side effects. Our results declare that lower CD34 yields after lowe dose G-CSF induction are probably not a troublesome issue affecting transplantation outcomes.
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Haider KH, Aziz S, Al-Reshidi MA. Endothelial progenitor cells for cellular angiogenesis and repair: lessons learned from experimental animal models. Regen Med 2017; 12:969-982. [PMID: 29215316 DOI: 10.2217/rme-2017-0074] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Stem/progenitor cell-based therapy has been extensively studied for angiomyogenic repair of the ischemic heart by regeneration of the damaged myocytes and neovascularization of the ischemic tissue through biological bypassing. Given their inherent ability to assume functionally competent endothelial phenotype and release of broad array of proangiogenic cytokines, endothelial progenitor cells (EPCs)-based therapy is deemed as most appropriate for vaculogenesis in the ischemic heart. Emulating the natural repair process that encompasses mobilization and homing-in of the bone marrow and peripheral blood EPCs, their reparability has been extensively studied in the animal models of myocardial ischemia with encouraging results. Our literature review is a compilation of the lessons learned from the use of EPCs in experimental animal models with emphasis on the in vitro manipulation and delivery strategies to enhance their retention, survival and functioning post-engraftment in the heart.
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Affiliation(s)
| | - Salim Aziz
- Department of CV Surgery, George Washington University, 2440 M Street NW, Suite 505, Washington DC 20037, USA
| | - Mateq Ali Al-Reshidi
- Department of Basic Sciences, Sulaiman Al Rajhi Colleges, Kingdom of Saudi Arabia
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