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Lupus

Stem Cell Therapy for Lupus

 

Systemic lupus erythematosus (SLE) is more prevalent among women of child-bearing age, and the female-male ratio is 15:8. This condition has an incidence of around 0.5%, and around 45% of patients have neurological symptoms. The cause of SLE is unknown, but experts believe genetics and environment are involved. The disease involves autoantibodies against the patient’s own body tissues. There is no cure for lupus, but stem cell therapy is proving to be useful in treatment.

Autologous hematopoietic stem cell transplantation has emerged as an effective new treatment in intractable SLE patients. Stem cell therapy has achieved sustained clinical and immunologic remissions, with 70% of patients being disease-free at five years. The goal of therapy is to “reset” the patient’s immune system by depleting autoreactive memory cells and reconstituting immunity by normalizing young T cells. In addition, stem cell therapy is associated with few side effects and adverse events.

MSCs for Lupus Therapy

Mesenchymal stem cells (MSCs) are anti-inflammatory, which makes them helpful as therapy for many autoimmune diseases. The do not have the properties that make them appear foreign to the body either. Umbilical cord-derived stem cells are more naïve and proliferative, which means they have great regeneration power. Expanded stem cells have the highest therapeutic effect, as each injection renders 20 million cells into the body.

Recent clinical findings show that Lupus patients have an unbalanced expression of growth factors and cytokines. In a large clinical study, patients with SLE were treated by stem cell transplantation. Of the patients, symptom scores decreased significantly at the follow-up appointments. In addition, proteinuria declined, and elevated renal functions normalized in many participants with renal involvement. In addition, most patients had decreased serum antinuclear antibody levels. Another four-year study found that half of the participants achieved complete clinical remission after transplantation.

Important Stem Cell Studies

A multi-center clinical study found that 33% of patients achieved major improved clinical response, and another 28% had partial response following stem cell therapy. The patients in this research trial received stem cell infusion, and required additional therapy at six months. In a case study, one patient with SLE and Sjogren’s syndrome received umbilical cord-derived mesenchymal stem cells (MSCs), along with globulin component protein macrophage activating factor therapy. After treatment, the patient enjoyed complete reversal of all laboratory and clinical markers.

In a large clinical study from Najing University Medical School, MSCs were used to treat refractory SLE patients. In the study, 87 people who had severe disease were treated intravenously with allogeneic bone marrow or umbilical cord MSCs. The patients were followed for four years. The overall survival rate was 94%, and at 2 years, the remission rate was 31%. At 4 years, the remission rate rose to 50%. Overall, experts agreed that stem cell therapy was a beneficial treatment for people with lupus.

A large observational study was conducted in Europe involving 900 patients with autoimmune diseases. Of these patients, the median age was 35 years, and 65% of patients were female. In this study, autologous hematopoietic stem cell transplantation was found to induce sustained remissions for more than five years in people with severe disease that did not respond to conventional therapy.

Resources

Alexander T, Thiel A, Rosen O, Massenkeil G, Sattler A, Kohler S, et al. Depletion of autoreactive immunologic memory followed by autologous hematopoietic stem cell transplantation in patients with refractory SLE induces long-term remission through de novo generation of a juvenile and tolerant immune system. Blood. 2009;113(1):214–223.

Alchi B, Jayne D, Labopin M, Demin A, Sergeevicheva V, Alexander T, et al. Autologous haematopoietic stem cell transplantation for systemic lupus erythematosus: data from the European Group for Blood and Marrow Transplantation registry. Lupus. 2013;22(3):245–253.

Burt RK, Traynor A, Statkute L, Barr WG, Rosa R, Schroeder J, et al. Nonmyeloablative hematopoietic stem cell transplantation for systemic lupus erythematosus. JAMA. 2006;295(5):527–535.

Farge D, Labopin M, Tyndall A, Fassas A, Mancardi GL, Van Laar J, et al. Autologous hematopoietic stem cell transplantation for autoimmune diseases: an observational study on 12 years’ experience from the European Group for Blood and Marrow Transplantation Working Party on Autoimmune Diseases. Haematologica. 2010;95(2):284–292.

Lehnhardt FG, Scheid C, Holtik U, Burghaus L, Neveling M, Impekoven P, et al. Autologous blood stem cell transplantation in refractory systemic lupus erythematodes with recurrent longitudinal myelitis and cerebral infarction. Lupus. 2006;15(4):240–243.

Phillips CD, Wongsaisri P, Htut T, & Grossman T (2017). Purified umbilical cord derived mesenchymal stem cell treatment in a case of systemic lupus erythematosus. Clin Transl Med, 6(31).

Statkute L, Verda L, Oyama Y, Traynor A, Villa M, Shook T, et al. Mobilization, harvesting and selection of peripheral blood stem cells in patients with autoimmune diseases undergoing autologous hematopoietic stem cell transplantation. Bone Marrow Transplant. 2007;39(6):317–329.

Statkute L, Traynor A, Oyama Y, Yaung K, Verda L, Krosnjar N, et al. Antiphospholipid syndrome in patients with systemic lupus erythematosus treated by autologous hematopoietic stem cell transplantation. Blood. 2005;106(8):2700–2709.

Wang D, Li J, Zhang Y, et al. (2014). Umbilical cord mesenchymal stem cell transplantation in active and refractory systemic lupus erythematosus: a multicenter clinical study. Arthr Res Ther, 16(2).

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