Resetting the immune response after autologous hematopoietic stem cell transplantation for autoimmune diseases

Author(s)

Arruda, L. C. M. ^{[1, 2]} ; Clave, E. ^{[3, 4, 5]} ; Moins-Teisserenc, H. ^{[3, 4, 5]} ; Douay, C. ^{[3, 4, 5]} ; Farge, D. ^{[3, 4, 6]} ; Toubert, A. ^{[3, 4, 5]}

Affiliation

^[1] Sao Paulo Res Fdn FAPESP, Ctr Cell Based Therapy, Ribeirao Preto - Brazil

^[2] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Biochem & Immunol, Ribeirao Preto - Brazil

^[3] Univ Paris Diderot, Sorbonne Paris Cite, Inst Univ Hematol, Paris - France

^[4] INSERM UMR1160, Paris - France

^[5] Hop St Louis, AP HP, Lab Immunol & Histocompatibilite, Paris - France

^[6] Hop St Louis, AP HP, Unite Clin Med Interne Malad Autoimmunes & Pathol, UF 04, F-75010 Paris - France

• Document type: Review article
• Source: CURRENT RESEARCH IN TRANSLATIONAL MEDICINE; v. 64, n. 2, p. 107-113, APR-JUN 2016.
• Web of Science Citations: 11

Abstract

Autologous hematopoietic stem cell transplantation (AHSCT) is currently investigated as treatment for severe and refractory autoimmune diseases, such as multiple sclerosis (MS), systemic sclerosis (SSc), Crohn's disease (CD) and systemic lupus erythematosus. Randomized clinical trials in MS, SSc and CD have shown the efficacy of AHSCT to promote control of disease activity and progression, when compared to conventional treatment. The use of high dose immunosuppressive conditioning is essential to eliminate the autoimmune repertoire, and the re-infusion of autologous hematopoietic stem cells avoids long-term leucopenia by reconstitution of both immune and hematological systems. Recent studies showed that AHSCT is able to deplete the autoimmune compartment and further promote the formation of a new auto-tolerant immune repertoire, reducing the inflammatory milieu and leading to long-term clinical remission without any complementary post-graft treatment. Deep knowledge about the mechanisms of action related to AHSCT-induced remission is required for the management of possible post-AHSCT relapse and improvement of clinical protocols. This paper will review the mechanisms enrolled in the immune response resetting promoted by AHSCT in patients with autoimmune diseases. (C) 2016 Elsevier Masson SAS. All rights reserved. (AU)

• FAPESP's process: 14/20922-2 - Evaluation of thymic function after autologous hematopoietic stem cell transplantation in systemic sclerosis patients
• Grantee: Lucas Coelho Marlière Arruda
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 13/18678-3 - Study of immunological mechanisms involved in the therapeutic response of patients with systemic sclerosis to autologous hematopoietic stem cells transplantation
• Grantee: Lucas Coelho Marlière Arruda
• Support Opportunities: Scholarships in Brazil - Doctorate