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Faraci M, Dell'Orso G, Giardino S, Pierri F. Autoimmune diseases after allogeneic stem cell transplantation: a clinician's guide and future outlook. Expert Rev Clin Immunol 2022; 18:1-14. [PMID: 35500169 DOI: 10.1080/1744666x.2022.2072299] [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: 03/11/2022] [Accepted: 04/27/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Autoimmune disease (AD) may occur after allogeneic hematopoietic stem cell transplantation (HSCT). The autoimmune mechanism seems to be related to an imbalance of the immune regulation effect of T-regulatory lymphocytes on autoreactive T-lymphocytes. AREAS COVERED ADs include hematological ADs (HADs) and nonhematologic ADs (NHADs) involving organs such as thyroid, peripheral and central nervous system, skin, liver, connective tissue, gastrointestinal tract, and kidney. To identify the risk factors for ADs, to report their clinical characteristics, and to discuss new approaches represent the areas covered in this review. EXPERT OPINION Some risk factors for HAD and NHAD are common and include nonmalignant diseases, young age, cord blood as a stem cell source, conditioning regimens without total body irradiation, alemtuzumab, antithymocyte globulin, T-cell-depleted transplant, some viral infection, mixed chimerism, and chronic Graft versus Host Disease. In NHADs, the detection of autoantibodies is more frequent and the transfer of autoimmunity from the donor to the recipient represents the pathogenetic mechanism responsible for these complications. New therapeutic approaches such as bortezomib, daratumumab, sirolimus, eculizumab, and eltrombopag appear to be promising in terms of better efficacy and reduced toxicity compared to traditional therapies. New horizons based on personalized therapies will allow us to improve the prognosis of AD.
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Affiliation(s)
- Maura Faraci
- Hematopoietic Stem Cell Unit, Department of Hematology-Oncology, IRCSS Istituto G. Gaslini I Istituto GGaslini, Genova, Italy
| | - Gianluca Dell'Orso
- Hematopoietic Stem Cell Unit, Department of Hematology-Oncology, IRCSS Istituto G. Gaslini I Istituto GGaslini, Genova, Italy
| | - Stefano Giardino
- Hematopoietic Stem Cell Unit, Department of Hematology-Oncology, IRCSS Istituto G. Gaslini I Istituto GGaslini, Genova, Italy
| | - Filomena Pierri
- Hematopoietic Stem Cell Unit, Department of Hematology-Oncology, IRCSS Istituto G. Gaslini I Istituto GGaslini, Genova, Italy
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Liang J, Wang D, Dominique F, Sun L. Mesenchymal stem cells for treating autoimmune diseases: The Chinese experience from lab to clinics. Curr Res Transl Med 2016; 64:115-20. [PMID: 27316395 DOI: 10.1016/j.retram.2016.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 04/13/2016] [Indexed: 12/29/2022]
Abstract
Autoimmune diseases are a group of chronic inflammatory conditions diseases characterized by aberrant activation of the immune system involving either cells or antibodies directed against normal tissues. The current conventional strategies, notably corticosteroids and immunosuppressors, are responsible for high treatment-related morbidity and are still associated with significant disease and treatment-related mortality. Recently, experimental and clinical data has suggested that mesenchymal stem cell transplantation would be a promising therapy strategy for the treatment of autoimmune diseases. This article will review the rationale and Chinese experience of mesenchymal stem cell transplantation in treatment of autoimmune diseases.
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Affiliation(s)
- J Liang
- Department of Immunology and Rheumatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu CN 210008, PR China
| | - D Wang
- Department of Immunology and Rheumatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu CN 210008, PR China
| | - F Dominique
- Assistance publique-Hôpitaux de Paris, Saint-Louis Hospital, Internal Medicine and Vascular Disease Unit, CIC-BT501, Inserm UMRS 1160, Paris 7 Diderot University, Sorbonne Paris Cité, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - L Sun
- Department of Immunology and Rheumatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu CN 210008, PR China.
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Poghosyan T, Catry J, Luong-Nguyen M, Bruneval P, Domet T, Arakelian L, Sfeir R, Michaud L, Vanneaux V, Gottrand F, Larghero J, Cattan P. Esophageal tissue engineering: Current status and perspectives. J Visc Surg 2015; 153:21-9. [PMID: 26711880 DOI: 10.1016/j.jviscsurg.2015.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Tissue engineering, which consists of the combination and in vivo implantation of elements required for tissue remodeling toward a specific organ phenotype, could be an alternative for classical techniques of esophageal replacement. The current hybrid approach entails creation of an esophageal substitute composed of an acellular matrix and autologous epithelial and muscle cells provides the most successful results. Current research is based on the use of mesenchymal stem cells, whose potential for differentiation and proangioogenic, immune-modulator and anti-inflammatory properties are important assets. In the near future, esophageal substitutes could be constructed from acellular "intelligent matrices" that contain the molecules necessary for tissue regeneration; this should allow circumvention of the implantation step and still obtain standardized in vivo biological responses. At present, tissue engineering applications to esophageal replacement are limited to enlargement plasties with absorbable, non-cellular matrices. Nevertheless, the application of existing clinical techniques for replacement of other organs by tissue engineering in combination with a multiplication of translational research protocols for esophageal replacement in large animals should soon pave the way for health agencies to authorize clinical trials.
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Affiliation(s)
- T Poghosyan
- Service de chirurgie digestive, oncologique et métabolique, hôpital Ambroise-Paré, AP-HP, 92100 Boulogne-Billancourt, France; CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J Catry
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Service de chirurgie générale, digestive et endocrinienne, hôpital Saint-Louis, AP-HP, 75010 Paris, France
| | - M Luong-Nguyen
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Service de chirurgie générale, digestive et endocrinienne, hôpital Saint-Louis, AP-HP, 75010 Paris, France
| | - P Bruneval
- Service d'anatomopathologie, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - T Domet
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Unité de thérapie cellulaire, hôpital Saint-Louis, AP-HP, 75010 Paris, France
| | - L Arakelian
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - R Sfeir
- Centre de référence des affections congénitales et malformatives de l'œsophage, CHRU de Lille, 59000 Lille, France
| | - L Michaud
- Centre de référence des affections congénitales et malformatives de l'œsophage, CHRU de Lille, 59000 Lille, France
| | - V Vanneaux
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Unité de thérapie cellulaire, hôpital Saint-Louis, AP-HP, 75010 Paris, France
| | - F Gottrand
- Centre de référence des affections congénitales et malformatives de l'œsophage, CHRU de Lille, 59000 Lille, France
| | - J Larghero
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Unité de thérapie cellulaire, hôpital Saint-Louis, AP-HP, 75010 Paris, France
| | - P Cattan
- CIC de biothérapies, Inserm UMR 1160, institut universitaire d'hématologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Service de chirurgie générale, digestive et endocrinienne, hôpital Saint-Louis, AP-HP, 75010 Paris, France.
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High dietary intake of vitamin C suppresses age-related thymic atrophy and contributes to the maintenance of immune cells in vitamin C-deficient senescence marker protein-30 knockout mice. Br J Nutr 2015; 113:603-9. [PMID: 25608928 DOI: 10.1017/s0007114514003857] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Vitamin C (VC) is an essential nutrient for humans and certain other animals. It has antioxidant properties and has been reported to ameliorate oxidative damage to lipids, DNA and proteins. However, the effects of VC on immune function are poorly understood, especially the influence of long-term high-dose VC intake on the number and function of immune cells. In the present study, to evaluate the immune effects of VC, VC-deficient senescence marker protein-30 knockout (SMP30KO) mice were fed a diet containing the recommended level of VC (20 mg/kg per d; 0·02 % VC) or a high level of VC (200 mg/kg per d; 0·2 % VC) for 1 year. The plasma VC concentration of the 0·02 % group was the same as that of age-matched C57BL/6 mice after 1 year of feeding; however, plasma VC concentration and thymus weight were significantly higher in the 0·2 % VC group than in the 0·02 % VC group. The total counts of leucocytes, lymphocytes, granulocytes and monocytes in the peripheral blood, as well as the number of splenocytes and thymocytes, were all significantly higher in the 0·2 % VC group than in the 0·02 % VC group. In addition, the number of naive T cells in peripheral blood lymphocytes, the number of memory T-cell populations in splenocytes, and the number of cluster of differentiation (CD)4⁺CD8⁺ or CD4⁺CD8⁻ or CD4⁻CD8⁺ T cells in thymocytes were all markedly higher in the 0·2 % VC group than in the 0·02 % VC group after 1 year of dietary treatment. These results suggest that a long-term high-dose intake of VC is effective in the maintenance of immune cells, partly through the suppression of age-related thymic involution in VC-deficient SMP30KO mice.
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Dimarino AM, Caplan AI, Bonfield TL. Mesenchymal stem cells in tissue repair. Front Immunol 2013; 4:201. [PMID: 24027567 PMCID: PMC3761350 DOI: 10.3389/fimmu.2013.00201] [Citation(s) in RCA: 293] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 07/04/2013] [Indexed: 12/23/2022] Open
Abstract
The advent of mesenchymal stem cell (MSC)-based therapies for clinical therapeutics has been an exciting and new innovation for the treatment of a variety of diseases associated with inflammation, tissue damage, and subsequent regeneration and repair. Application-based ability to measure MSC potency and fate of the cells post-MSC therapy are the variables that confound the use of MSCs therapeutics in human diseases. An evaluation of MSC function and applications with attention to detail in the preparation as well as quality control and quality assurance are only as good as the assays that are developed. In vivo measures of efficacy and potency require an appreciation of the overall pathophysiology of the model and standardization of outcome measures. The new concepts of how MSC’s participate in the tissue regeneration and wound repair process and further, how this is impacted by estimates of efficacy and potency are important new topics. In this regard, this chapter will review some of the in vitro and in vivo assays for MSC function and activity and their application to the clinical arena.
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Affiliation(s)
- Amy M Dimarino
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University , Cleveland, OH , USA
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Kishk NA, Abokrysha NT, Gabr H. Possible induction of acute disseminated encephalomyelitis (ADEM)-like demyelinating illness by intrathecal mesenchymal stem cell injection. J Clin Neurosci 2012; 20:310-2. [PMID: 23157845 DOI: 10.1016/j.jocn.2012.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 02/23/2012] [Accepted: 04/06/2012] [Indexed: 12/13/2022]
Abstract
We report a 27-year-old woman with an episode of encephalitis and optic neuritis, followed by autologous bone marrow mesenchymal stem cell transplants and possible induction of acute disseminated encephalomyelitis-like demyelinating illness.
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Affiliation(s)
- Nirmeen A Kishk
- Department of Neurology, Cairo University, Kaser Al-Aini Hospital, Al-Manyal Street, Garden City, Cairo 11562, Egypt
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Steinert AF, Rackwitz L, Gilbert F, Nöth U, Tuan RS. Concise review: the clinical application of mesenchymal stem cells for musculoskeletal regeneration: current status and perspectives. Stem Cells Transl Med 2012; 1:237-47. [PMID: 23197783 PMCID: PMC3659848 DOI: 10.5966/sctm.2011-0036] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 01/12/2012] [Indexed: 12/12/2022] Open
Abstract
Regenerative therapies in the musculoskeletal system are based on the suitable application of cells, biomaterials, and/or factors. For an effective approach, numerous aspects have to be taken into consideration, including age, disease, target tissue, and several environmental factors. Significant research efforts have been undertaken in the last decade to develop specific cell-based therapies, and in particular adult multipotent mesenchymal stem cells hold great promise for such regenerative strategies. Clinical translation of such therapies, however, remains a work in progress. In the clinical arena, autologous cells have been harvested, processed, and readministered according to protocols distinct for the target application. As outlined in this review, such applications range from simple single-step approaches, such as direct injection of unprocessed or concentrated blood or bone marrow aspirates, to fabrication of engineered constructs by seeding of natural or synthetic scaffolds with cells, which were released from autologous tissues and propagated under good manufacturing practice conditions (for example, autologous chondrocyte implantation). However, only relatively few of these cell-based approaches have entered the clinic, and none of these treatments has become a "standard of care" treatment for an orthopaedic disease to date. The multifaceted reasons for the current status from the medical, research, and regulatory perspectives are discussed here. In summary, this review presents the scientific background, current state, and implications of clinical mesenchymal stem cell application in the musculoskeletal system and provides perspectives for future developments.
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Affiliation(s)
- Andre F. Steinert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Orthopaedic Center for Musculoskeletal Research, Julius-Maximilians-University, Würzburg, Germany
| | - Lars Rackwitz
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Orthopaedic Center for Musculoskeletal Research, Julius-Maximilians-University, Würzburg, Germany
| | - Fabian Gilbert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Orthopaedic Center for Musculoskeletal Research, Julius-Maximilians-University, Würzburg, Germany
| | - Ulrich Nöth
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Orthopaedic Center for Musculoskeletal Research, Julius-Maximilians-University, Würzburg, Germany
| | - Rocky S. Tuan
- Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Suppression of the PI3K-Akt pathway is involved in the decreased adhesion and migration of bone marrow-derived mesenchymal stem cells from non-obese diabetic mice. Cell Biol Int 2012; 35:961-6. [PMID: 21449895 DOI: 10.1042/cbi20100544] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
T1DM (type 1 diabetes mellitus) is an autoimmune disease characterized by T-cell-mediated damage of islet β-cells. The pathology of NOD (non-obese diabetic) mouse involves the insulitis induced by infiltration of T-cells, a similar pathogenic mechanism in T1DM patient. BM-MSCs (bone marrow mesenchymal stem cells) are multipotent progenitor cells that can be isolated from a number of sources. Recent studies have shown that transplantation of MSCs to the NOD mice could prevent the process and have the therapeutic effects on T1DM. In our studies, we have found that migration and adhesion of BM-MSCs from NOD mice were suppressed compared with the BM-MSCs from ICR (imprinting control region) mice, accompanying with the abnormal distribution of FAK (focal adhesion kinase) and F-actin (filamentous actin). Further, we have found that the activation of PI3K (phosphoinositide 3-kinase)-Akt pathway was suppressed in BM-MSCs from NOD mice. When the PI3K-Akt pathway was inhibited by LY294002, the adhesion and migration of BM-MSCs from ICR mice were suppressed as well. These results indicated that the suppression of PI3K-Akt pathway is involved in the decreased adhesion and migration of BM-MSCs from NOD mice.
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García-Gómez I, Elvira G, Zapata AG, Lamana ML, Ramírez M, Castro JG, Arranz MG, Vicente A, Bueren J, García-Olmo D. Mesenchymal stem cells: biological properties and clinical applications. Expert Opin Biol Ther 2011; 10:1453-68. [PMID: 20831449 DOI: 10.1517/14712598.2010.519333] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE OF THE FIELD In the last decade, knowledge of mesenchymal stem cells (MSCs) has evolved rapidly; their immunomodulatory properties and paracrine interactions with specific cell types in damaged tissues and promising results in some clinical applications have made these cells an attractive option for the treatment of certain diseases. AREAS COVERED IN THIS REVIEW We present some relevant methodological issues and biological properties of MSCs, as well as clinical applications of MSC therapies with particular emphasis in the treatment of graft versus host disease (GVHD), complex perianal fistula and refractory metastatic neuroblastoma. Other topical aspects relevant to the application of cellular therapies such as biosafety studies and cellular production of MSCs are also discussed in this review. WHAT THE READER WILL GAIN The growing optimism regarding MSCs research is based on the promising results obtained in in vitro and in vivo studies. The rapid translational research with MSCs necessitated standardization of methodology and terminology and greater focus on other aspects such as biosafety and cellular production, especially for clinical use of MSCs. TAKE HOME MESSAGE Much has been learned about the biology and applications of MSCs and much remains to be learned.
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Affiliation(s)
- Ignacio García-Gómez
- Autonoma University-La Paz University Hospital (idiPAZ), Laboratory of Cell Therapy, Madrid, Spain
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Mesenchymal stem cells targeting the GVHD. ACTA ACUST UNITED AC 2009; 52:603-9. [PMID: 19641864 DOI: 10.1007/s11427-009-0091-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Accepted: 06/14/2009] [Indexed: 12/20/2022]
Abstract
Acute graft-versus-host disease (GVHD) occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. About 35%-50% of hematopoietic stem cell transplant (HSCT) recipients will develop acute GVHD. It is associated with considerable morbidity and mortality, particularly in patients who do not respond to primary therapy, which usually consists of glucocorticoids(steroids). Most of the available second-line and third-line treatments for steroid-refractory acute GVHD induce severe immunodeficiency, which is commonly accompanied by lethal infectious complications. Mesenchymal stem cells (MSCs) have been shown to mediate immunomodulatory effects. The recently elucidated immunosuppressive potential of mesenchymal stem cells has set the stage for their clinical testing as cellular immunosuppressants, MSCs have been used in patients with steroid-refractory acute GVHD, and encouraging responses have been obtained in many studies. The utility of MSCs for the treatment of GVHD is becoming clear.
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